Endocrine Abstracts

Background: Testosterone replacement therapy in severe hypogonadism is indicated, however, the treatment of late onset hypogonadism (LOH) is debated, especially what the diagnostic criteria should be. In LOH bio-available testosterone probably gives a more accurate index of gonadal status as a diagnostic criterion as it takes SHBG into consideration. SHBG is known to increase with ageing, however, SHBG is also negatively influenced by insulin and visceral adiposity.<p clas...

Introduction and methods: Despite advances in diabetes treatment, diabetic ketoacidosis (DKA) remains a significant cause of morbidity. We performed a 5-year retrospective analysis of DKA episodes (2004–2008). Results were compared with an earlier study (1997–2001).Results: Ninety-four episodes of DKA (defined as hyperglycaemia, ketosis and acidosis) were identified through Hospital Inpatient Enquiry (HIPE). Patients with Type 1 diabetes mellit...

Aim: In the thyrotoxicosis local investigation protocol, Tc99m pertechnetate scintigraphy technetium scan is used to assess the presence of thyroid uptake and both the degree and pattern of uptake. TSH receptor antibodies are used to demonstrate the presence and activity of autoimmune thyroid disease. We audited the utility of these investigations in a series of thyrotoxic patients.Methods: Forty-nine patients (11 men, 38 women, mean age 47.5±38) we...

A 19-year-old, female of West African descent presented with a 5 months history of thyrotoxicosis. The GP had commenced carbimazole. She had continuing clinical and biochemical thyrotoxicosis TSH <0.01 (0.3–5.5 mU/l), FT4 68.0 (9–20 pmol/l) and FT3 18.9 (3.4–5.6 pmol/l). Thyroid antibodies were present at elevated titre and technetium uptake scanning showed toxic diffuse hyperplasia with an uptake function of 37%, confirming Graves&#146...

Thyroid cancer is the most common endocrine malignancy. However, some aspects of its management remain controversial. The protocols provided by the British, European and American Thyroid Associations have changed recently and continue to evolve.We have audited the management of patients with thyroid cancer in a tertiary referral hospital and compared it with the guidelines from the Consensus Statement published by the European Thyroid Cancer Taskforce in...

Renal impairment and electrolyte disorders in hypothyroidism are frequently subtle and rarely observed in clinical practice. Case reports have noted the association but it is rarely found in textbooks. We describe a case of new onset renal dysfunction secondary to hypothyroidism. A 54-year-old male was referred to renal clinic with new renal failure. He described a 3 weeks history of sudden onset peri-orbital, facial and generalised leg swelling and associated muscle ache and ...

In addition to their documented impact on the cardiovascular system, polyunsaturated fatty acids (PUFAs) have also been shown to modulate steroidogenesis. However, the mechanistic nature of PUFA action on steroid synthesis remains unknown. PUFAs are recognised modulators of cholesterol trafficking. Liver X receptor (LXR) is a known cholesterol sensor that regulates a range of genes involved in cholesterol metabolism including Steroidogenic acute regulatory protein (StAR) which...

Mutation in the genes encoding subunits of the succinate dehydrogenase enzyme complex, SDHB, SDHC and SDHD are associated with an increased risk of developing adrenal or extra-adrenal phaeochromocytoma and cervical paraganglioma. However, the penetrance in large kindreds has seldom been reported and the optimal screening for asymptomatic carriers has not been determined.The index case had a previous history of carotid body tumour and later died with meta...

Background: Measurement of urinary cortisol is commonly used in the investigation of suspected Cushing’s Syndrome and is most often performed using immunoassay. This approach exhibits significant assay variability necessitating the use of method specific reference ranges. A reference range for cortisol nmol/L: creatinine mmol/L ratio is reported based on the results from 104 early morning urine samples collected from healthy individuals and analysed using the AutoDelfia A...

Background: The paediatric diabetes team at our Children’s Hospital were part of a national clinical trial considering whether long term outcomes are better for patients on MDI (multiple daily injection therapy) or insulin pump therapy from diagnosis. Patients and their families had to be approached, consented and treatment for the trial commenced within two weeks of diagnosis. Many centres struggled to recruit, but this was not the case with our centre.<p class="abst...