Endocrine Abstracts

Background: PAPP-A2 is a protease which helps to release IGF-1 from a ternary complex by cleaving the IGF binding proteins (IGFBP-3 and -5). Free IGF-1 subsequently binds to its receptor resulting in cell proliferation and growth. Homozygous loss-of-function PAPPA2 mutations lead to low IGF-1 bioavailability and postnatal short stature (SS). Recombinant human IGF-1 (rhIGF-1) treatment improves height SDS in few patients. We report a patient with SS and high plasma tot...

TSHoma is rare, with an incidence of 1 per million, and <1% of all pituitary tumours. We reported a case involving a 49-year-old female who was first referred to our endocrine unit in 2006 with excessive lethargy and abnormal TFT’s. She was thought to have thyroid hormone resistance for several years until 2015 when she reported having persistent symptoms and further investigation suggested an alternative diagnosis.Results: Ft4=41.6 pmol/l, TSH=...

Background: The use of intra-articular (IA) glucocorticoids for reducing pain and inflammation in patients with osteoarthritis, rheumatoid arthritis, and other inflammatory arthropathies is widespread among primary care physicians, specialists and non-specialists in the United States. Injectable glucocorticoids have anti-inflammatory and analgesic properties which can be effective in improving clinical parameters such as pain, range of motion, and quality of life. After inject...

Background: Diabetic retinopathy is a frequent cause of vision loss in young adults. NICE guidelines require services to offer annual retinal screening to all diabetic children aged ≥12 years. A local 2009–2010 audit identified 57% underwent screening but only 16% had results documented with the paediatric diabetes service, both areas requiring improvement. In 2011, the paediatric diabetes service formulated a standard operating procedure with the eye-screening prog...

Objective: To evaluate the outcome of fine needle aspiration biopsy (FNAB) of solid thyroid nodules, and the utility of thyroid ultrasound in determining the nature of solid nodules in our practice.Methods: We reviewed the diagnostic outcome of FNAB of solid thyroid nodules in 93 patients from our dedicated thyroid biopsy clinic. In addition we compared the predictive value of sonographic assessment with FNAB in a subset of patients who had undergone bot...

Although pituitary abnormalities are the most commonly reported endocrine feature in septo-optic dysplasia, other endocrine abnormalities have not been described so far. We present a case of septo-optic dysplasia (SOD) and pituitary dysfunction, complicated by X-linked adrenoleucodystrophy (X-ALD) and primary adrenal insufficiency.A 4-year-old boy was referred with hypoglycaemic episodes and seizures during intercurrent illnesses. He had a history of pol...

Heterophilic antibody interference in serum TSH immunoassays can result in misdiagnosis of patients with suspected thyroid disease. Rheumatoid factor (RhF) is an immunoglobulin with reactivity to the Fc portion of human IgG. Some RhF species also cross-react with animal immunoglobulins so have the potential to act as heterophile antibodies. As part of the Cambridge Supra-Regional Assay service for thyroid function testing five serum samples with strongly positive RhF and posit...

Background: Antithyroid drugs include thioimidazoles (carbimazole, methimazole) and propylthiouracil. Carbimazole is most commonly used in the UK. A fixed drug eruption is the drug-induced cutaneous reaction which occurs at the same site after each exposure to that agent. It is uncommon with anti-thyroid medications. Here we report this rare presentation. A 40-year-old Chinese lady who was diagnosed with Graves’ disease was initially treated with carbimazole, and then wit...

Introduction: Autoimmune thyroiditis is rarely painful. A tender goitre usually indicates viral thyroiditis. Here, we present a case of a persistent painful goitre due to sclerosing-type Hashimoto’s thyroiditis.Case presentation: Our patient is a 27-year-old mother, with no significant past medical history. She was diagnosed with autoimmune hypothyroidism in October 2005 when 4 months post-partum. At diagnosis her anti-TPO titre was 2041 U/ml...

Generalised resistance to thyroid hormone (GRTH), a subset of the syndrome of resistance to thyroid hormone (RTH), is characterised by variable reduced target tissue responsiveness to circulating thyroid hormones. Plasma thyroid hormone levels are raised and TSH levels inappropriately non-suppressed. We describe a 54-year-old female with GRTH diagnosed from the finding of raised fT4 and fT3 levels coincidental with non-suppressed TSH levels. A thyrotropin (TRH) test resulted i...