Endocrine Abstracts

Thyroid hormone resistance is a rare condition, caused by mutations of the thyroid hormone receptor beta (THRB) gene, inherited in an autosomal dominant manner, resulting in decreased tissue sensitivity to thyroid hormone action, leading to high FT4 levels with normal TSH levels. We present a case of thyroid hormone resistance, initially misdiagnosed and treated as hyperthyroidism. An 8 year old girl was referred due to poor appetite, FT4 level was elevated (38.5 pmol/l) with ...

Aim: To determine patient outcomes following radioactive iodine (I131) therapy in a UK district general hospital for the treatment of benign thyroid disease.Methods: A record of all patients at University Hospital Hairmyres (Scotland, UK) undergoing radioactive iodine therapy for benign thyroid disease was kept. Patients were identified using a unique community health index (CHI) number. A retrospective case note review was then carried out fo...

Clinical Endocrinology 2015 82 136–141. DOI: 10.1111/cen.12559...

The aim of this study was to investigate seasonal variation in haemoglobin A1c (HbA1c) using a retrospective population analysis linking HbA1c values to the time of year. The study cohort included 171 442 NHS patients from Scotland, UK. Patients were divided into three groups. The ‘stable group’ were defined as having a HbA1c that varied less than the tertile either side of the mean HbA1c. The ‘high summer’ was comprised of ...

A 58-year-old non-diabetic Caucasian man was admitted with a capillary glucose of 1.9 mmol/l following an episode of confusion and disorientation. During his admission he had frequent episodes of nocturnal and early morning hypoglycaemia with capillary glucose <3.0 mmol/l. After 21 h of supervised fasting he was symptomatic with plasma glucose 2.3 mmol/l, insulin >1000 mU/l and C-peptide 19.6 μg/l. Sulphonylurea screen was negative. Given the magnitude of serum in...

A 60-year-old man presented with symptomatic primary hyperparathyroidism. At this time serum corrected calcium was 3.1 mmol/l (2.15–2.65 mmol/l) and after investigation bilateral parathyroid exploration was performed. A suspected adenoma was identified in the right inferior gland and removed. The remaining glands appeared normal. The adenoma was confirmed histologically. Early post-operative calcium was normal (2.48 mmol/l).He remained well and calc...

A 45-year-old man who works as a psychotherapist was referred with an incidental finding of a rudimentary uterus and bilateral pelvic gonads on pelvic computerized tomogram and magnetic resonance imaging. This was performed for investigation of abdominal pain which has since settled. As far as he is aware he was born without complications and developed normally through childhood. He progressed through puberty uneventfully with voice changes by 13 years and shaving by 16 years....

A large population-based cohort of “diagnosed” primary hyperparathyroidism (PHPT) (n=2709) was established, 1997–2006, in Tayside, Scotland. We have previously reported on an increasing prevalence and increased risks of mortality and morbidity associated with these patients. In the course of the PEARS, a group of “possible” PHPT cases (n=2950) defined as having persistently elevated serum calcium over several months to years but with no P...

Background: Graves’ hyperthyroidism is treated with anti-thyroid drugs (ATD) for 12–18 months, after which ~50% of patients remain euthyroid. Risk factors predicting relapse are: male gender, younger age, orbitopathy, large goitres, severe hyperthyroidism at diagnosis and smoking. Recent reports suggest measurement of TBII at ATD cessation is useful in predicting risk of relapse. Aim: To prospectively investigate whether TBII levels at cessation of ATD therapy are us...

Context: Rising evidence of the increased risk in mild PHPT suggests that serum calcium, which has been a main surgical criterion, maybe not an accurate indicator of disease severity or at least, not a reliable predictive factor of its long-term consequences. This study aims to identify the best biochemical predictor of adverse outcomes in untreated PHPT.Outcome measures and methods: Primary outcomes considered were all-cause mortality, fatal and non-fat...