Endocrine Abstracts

Generous glucocorticoid (GC) replacement following pituitary or adrenal surgery for Cushing’s can result in persistent suppression of the pituitary corticotrophs, evidenced by poor short synacthen test (SST) responses. Dose reduction can result in increased fatigue so patients tend to prefer to remain on higher doses. Long-term GC therapy is associated with increased morbidity and mortality. We present two cases where GC therapy was successfully weaned through a gradual t...

Background: Patients with adrenal insufficiency (AI) require glucocorticoid replacement therapy. Current Endocrine Society guidelines recommend thrice-daily hydrocortisone (15-25mg) or once-daily prednisolone (3-5mg). Concerns around prednisolone use have been based on evidence using higher doses. We have been using low-dose (2-4mg) once-daily prednisolone since 2014 for glucocorticoid replacement in adult patients with AI. This study aimed to compare the effe...

Background: Adrenal Insufficiency (AI) is a life-threatening disorder caused by dysfunction of the adrenal axis (primary AI) or of the hypothalamic-pituitary-adrenal axis (secondary AI). Both result in glucocorticoid deficiency, requiring life-long replacement, with additional mineralocorticoid replacement required in primary AI. However, accurately reproducing the endogenous circadian and ultradian rhythm of cortisol secretion is challenging. Current Endocrin...

Background: The Controlled Antenatal Thyroid Screening II (CATS) study, a large randomised trial of thyroxine supplementation for suboptimal gestational thyroid function (SGTF), reported a higher prevalence of elevated attention deficit hyperactivity disorder (ADHD) scores in 9 year-old children exposed to higher thyroid hormone (TH) in utero. Here we investigated if this was accompanied by altered neurodevelopment.Methods: 85 children aged 11-1...

Background: Serum thyroglobulin (Tg) is a useful marker of recurrent or persistent disease in the follow-up of patients with differentiated thyroid carcinoma (DTC); the presence of interfering Tg antibodies (TgAb), even in low concentrations, can lead to a distorted evaluation of this marker. However, TgAb by itself has been shown to be a marker of disease following surgery. TgAb recognition of Tg epitopes differs in pathological and non-pathological states and may thus have p...

The cohort comprised 2296 patients with Graves’ disease (GD) (1920 females, 376 males) and 361 with Hashimoto’s thyroiditis (HT) (313 females, 48 males) recruited using standard diagnostic criteria for investigation of genetic susceptibility to AITD. We investigated variation in disease phenotype with age and gender, examining factors including biochemical severity, presence of goitre and presence of thyroid eye disease (TED) classified by NOSPECS score.<p class=...

Autoimmune thyroid diseases (AITD), Graves’ disease (GD) and Hashimoto’s thyroiditis (HT) cluster in families. We investigated whether having a family history (FH) of AITD altered age of diagnosis. The cohort comprised 2296 GD (1920F,376M) and 361 HT (313F,48M) recruited according to standard diagnostic criteria. We compared age at diagnosis of GD or HT in those with or without a FH of overt hyper- or hypothyroidism (ascertained using a standardised questionnaire).</...

The association of autoimmune thyroid diseases (AITD) with other autoimmune disorders is well documented. Familial prevalence of thyroid dysfunction and other autoimmune diseases was examined in our cohort of 2296 with Graves’ disease (GD) (1920 females, 376 males) and 361 with Hashimoto’s thyroiditis (HT) (313 females, 48 males), probands being recruited using standard diagnostic criteria. FH was ascertained using a standardised structured questionnaire.<p class...

A 65-year-old female with PTEN Hamartoma Tumour Syndrome, Follicular thyroid carcinoma, and Endometrial Carcinoma, presented at a tertiary centre due to an asymptomatic adrenal lesion. Previous genetic testing for phaeochromocytoma and paraganglioma in 2020 showed no pathogenic variants in multiple genes (FH, MAX, MEN1, SDHx, SDHAF2, TMEM127, VHL, RET gene). Recent imaging revealed a 9 cm left supra-renal lesion that had been gradually increasing in size since 2010. Plasma nor...

Introduction: The Controlled Antenatal Thyroid Screening II (CATS) study, a large randomised trial of thyroxine supplementation for suboptimal gestational thyroid function (SGTF), reported higher attention deficit hyperactivity disorder (ADHD) scores in 9 year-old children exposed to higher thyroid hormone (TH) in utero. We investigated if this was accompanied by altered myelination.Methods: Eighty-five children...