Endocrine Abstracts

A 54-year-old man with a recurrent non-functioning pituitary gonadotroph adenoma previously treated with transphenoidal surgery (TSS) in 2015, presented to Charing Cross hospital for repeat transsphenoidal surgery in May 2022. Since his initial surgery, he remained on Levothyroxine 50 μg once daily only. There was no evidence of adrenal insufficiency (0900 h cortisol 333 nmol/l at day 6 following initial TSS). In February 2022, his electrolytes, FSH, LH, testosterone, pro...

Objectives: Pregnancy and early infancy are periods when increased demand for thyroid hormone can result in subclinical hypothyroidism (SH). SH is frequently a prodrome to autoimmunity, but may be a compensation mechanism for an underlying genetic defect. The W546X mutation of the thyrotropin receptor (TSHR) is present at a frequency of 1 in 180 in a Caucasian population. We aimed to investigate whether W546X was the cause of SH presenting in pregnancy and early infancy.<p...

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...

Thyroid physiology in early pregnancy is characterised by an increase of thyroxine binding globulin. This has been taken into account when using total T4 (TT4) if a ‘T3 uptake test (TUp)’ is used to derive the FTI. The American Thyroid Association Guidelines (1990) recommend ceasing the use of uptake tests, although in the USA they are still widely used. The aim of this study is to compare the TT4 and TUp to the FT4 in early gestation. TT4, TUp, FT4 and TSH were meas...

Thyroid hormone resistance (THR) is associated with elevated FT4 and FT3 with inappropriately high TSH levels. T3 action is mediated by two types of thyroid hormone receptor, encoded by alpha and beta genes. We evaluated the endothelial function of a THR transgenic mouse model with a targeted mutation in the thyroid hormone beta receptor gene ex vivo.Isometric tension of aortic rings of 10 mice of each genotype (TRbPV/PV, TRbPV/+</...

ObjectiveDoes subclinical hypothyroidism (SCH)cause increased cardiovascular risk and how does treatment affect cardiac and vascular function in patients with SCH?MethodsCardiac function and central arterial stiffness(CAS)were measured in 20 females (mean age 50.1 plus/minus 4.1 years)with SCH (mean free T4 12.2 plus/minus 0.2 picomol per litre [normal range 9.8-22.1],median TSH 8.8 milliunits per litre[norma...

This study aims to recruit 22,000 women in early gestation to screen for thyroid failure. The trial is randomised such that half the women are being tested in early gestation (group1) while the remainder (group 2) are tested after delivery. As T4 is important for the developing foetal brain, the IQ of the children from group 1, whose mothers will have been treated with T4, is expected to be higher than that from group 2.Women are entered on the basis of ...

Normal pregnancy is associated with significant but reversible changes in thyroid function. However, maternal thyroid dysfunction during early pregnancy has been associated with neuro-intellectual impairment of the child. The CATS study, a randomised controlled study, has been initiated in order to ascertain if screening for abnormalities in thyroid function in early pregnancy (8 - 16 weeks gestation), with thyroxine replacement in appropriate cases, would be effective in redu...

Experimental evidence suggests that leptin plays an important role in modulation of cell-mediated immunity in organ-specific autoimmune diseases. This longitudinal study evaluates changes in serum leptin values in relation to development and outcome of postpartum thyroiditis (PPT). Materials and Methods: Fifty postpartum (6 week) euthyroid women with elevated thyroglobulin (TgAb) and/or thyro-peroxidase (TPOAb) antibodies were investigated. Body mass index (BMI), serum leptin ...

Introduction: We recently reported a high prevalence of |TgAb in sera from healthy Sri Lankan subjects. To characterise these further we have studied the reactions of these Abs with Tg in a competitive ELISA with a panel of 10 Tg monoclonal Abs (TgMabs). This is compared to a similar UK population of healthy subjects and AITD patients.Methods: The sera, all from females, comprised: 1. Healthy SL schoolgirls with high TgAb (HSL; n=33) 2. Healthy SL Tamil...