Endocrine Abstracts

We present 2 patients who developed severe thyrotoxic exacerbation following radioiodine. The first treated by conventional antithyroid therapy, the second was plasma exchanged.Patient A aged 39 male with FT3=28.2 pmol/l (2.5–5.3) FT4=49.0 pmol/l (9.1–23.8) TSH=<0.01 mU/l (0.32–5.0),a large diffuse goitre, thyroid eye disease and asthmatic on inhaled ventolin. He received 3.5 years of carbimazole 40 mg and thyroxine 100 mcg. Thyroxine ...

Mrs X (aged 79) had a history of longstanding hypothyroidism (levothyroxine 100 micrograms daily). Her Free T4 (FT4) had been slightly raised with normal TSH until in Dec 2019, where both became elevated (TSH 5.4 mU/l and FT4 29.4 pmol/l). Repeat TFT in January 2020 also showed the same. Mrs X felt well on Levothyroxine, with no thyrotoxic features. Endocrine clinic investigations (October 2020) showed no evidence of assay interference. Alternative diagnoses such as thyrotropi...

Introduction: Autoimmune thyrotoxicosis (AT) affects 2-5% of the Western population. Despite current NICE guidelines recommending radioiodine as first-line treatment for AT, practical considerations such as licensing often prevent this. Typically, anti-thyroid medication (carbimazole or propylthiouracil) is initially offered. Patients are usually counselled that the remission rate following a 12-18 month course of anti-thyroid medication is approximately 50%.<p class="abst...

Background: With advances in radiological technology, the detection of incidentally discovered pituitary abnormalities is increasing, 90% being secondary to pituitary adenomas. Patient morbidity increases when these lesions are large enough to cause hormone insufficiency or visual field defects, highlighting the importance of appropriate management.Aim: To evaluate management of patients with pituitary incidentaloma in accordance with national guidelines...

INTRODUCTION: Although IGF-I is considered to reflect the daily GH secretion, its value in establishing the diagnosis of adult growth hormone deficiency (GHD) and in predicting the presence of further anterior pituitary deficits has not been elucidated in a large series.AIM: To evaluate the diagnostic utility of a subnormal IGF-I in patients with GHD and to investigate whether a low IGF-I is associated with the presence of further anterior pituitary defi...

Mutations in the HSD11B2 gene explain the syndrome of apparent mineralocorticoid excess (AME), which is characterised by severe hypokalaemic hypertension. Cortisol acts as a mineralocorticoid through failure of its inactivation to cortisone by 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2). Patients are diagnosed by a raised THF+allo-THF/THE ratio. To date, approximately 30 mutations have been described in HSD11B2. Recently, three apparently unrelated kindreds with A...