Endocrine Abstracts

Aim: Focussed parathyroidectomy is an established technique in subjects where imaging has identified a single parathyroid lesion. The aim of this study was to examine the long-term cure rate following this procedure.Method: Of 188 patients undergoing surgery for primary hyperparathyroidism between 2001 and 2006, 150 had a single parathyroid lesion on imaging using sestamibi +/− neck ultrasound. These patients were treated by focused parathyroidecto...

Primary hyperparathyroidism in pregnancy is reported as being rare rare. It can be associated with significant complications. Maternal complications include symptomatic hypercalcaemia, renal calculi, hyperemesis, muscle weakness, and pre-eclampsia. Fetal complications include IUGR, low birth weight, preterm delivery, intrauterine death, neonatal tetany and fits.Patient 1 presented with asthma and was found to have primary hyperparathyroidism, corrected c...

A 44 yr old IT systems analyst, presented in 2003 with a six month history of weight gain, diabetes and hypertension. On examination he was floridly Cushingoid. Investigations showed raised 9AM cortisol (1887 nmol/l) with failure to suppress following low and high dose dexamethasone, together with elevated 24 h urinary free cortisol (3300 nmol) and circulating ACTH (130 ng/l) levels. CT scan demonstrated a complex 11.5×9 cm lesion in the left lobe of liver and biopsy indi...

Resistance to thyroid hormone (RTH) is a rare, autosomal dominant disorder characterised by a reduced sensitivity of peripheral tissues to thyroid hormone. Thyroid function testing shows elevation of free T4 and T3 with non suppressed TSH levels.Vascular function in these patients has not been fully evaluated. We have studied central arterial stiffness in a cohort of RTH patients, comparing them with age and sex matched controls.Me...

We report a rare case of acute myeloid leukaemia (AML) with high risk cytogenetics and associated hypothalamic diabetes insipidus (HDI).A 48-year-old female presented to her GP with a 3-month history of tiredness and lethargy. Full blood count revealed haemoglobin 7.0 g/dl (MCV 103fl), white cell count 12.1×109/l (neutrophils 1.33×109/l), platelets 91×109/l; circulating blast cells were evident on the perip...

We report a falsely elevated blood spot thyrotrophin (TSH) concentration caused by a TSH-IgG complex. A routine blood spot screen returned a whole blood TSH of 213 mU/l from a one week-old neonate using the Wallac DELFIA method. Measurement in serum confirmed elevated TSH (826 mU/l, Roche Elecsys assay) but free thyroxine (17.2 pmol/l) was normal. The baby’s mother was clinically euthyroid but also showed discordant high serum TSH (287 mU/l) with normal free thyroxine (13...

Guidelines for the use of Growth Hormone (GH) replacement in adults with GH deficiency (GHD) were published by the National Institute for Clinical Excellence (NICE) in 2003. We undertook an audit to ensure that patients attending our adult endocrinology clinic were being prescribed GH in accordance with NICE guidelines.Patients commenced on GH replacement between June 2004 and June 2005 were included in the audit. Data was collected from medical notes, a...

Three siblings of Pakistani origin presented shortly after birth with failure to thrive and hyperkalemia and were found to have isolated hyperreninaemic hypoaldosteronism. They were all well controlled on fludrocortisone therapy during childhood and adolescence. When reassessed in adult life off fludrocortisone treatment, hyperreninaemic hypoaldosteronism was confirmed in all subjects, but with significant hyperkalemia in only one case. None of the subjects developed orthostat...

Radioiodine (RAI) is widely used for the treatment of thyrotoxicosis. The efficacy and hypothyroidism rate following a single dose of RAI is variable and the optimum administered dose – sufficient to achieve remission but with an acceptable low hypothyroidism rate, is still debated.Our audit sought to compare the results of local practice with published rates of success and hypothyroidism following RAI. We also examined the relationship between trea...

Multiple Endocrine Neoplasia Type 2B is a dominantly inherited disorder characterised by mucosal neuromas, medullary thyroid carcinoma (MTC), phaeochromocytoma, and intestinal ganglioneuromatosis. We report the case of a 34-year-old woman who presented with chronic diarrhoea. She had a longstanding history of gastrointestinal symptoms including diarrhoea since the age of 7 and had been investigated extensively for over 20 years at three different centres, but no definitive dia...