Endocrine Abstracts

Background: Central hypothyroidism can be difficult to diagnose as TSH values often reside within the normal range. The Endocrine Society clinical guideline for hormone replacement in hypopituitarism suggests levothyroxine is indicated for treatment of secondary hypothyroidism where fT4 levels decrease by ≥20%. To determine the reliability of this biochemical marker of secondary hypothyroidism we evaluated evolution of TFTs over time within a cohort of NFPA.<p class=...

Background: Prevalence of Addison’s disease (AD) among patients with Type 1 diabetes mellitus (T1DM) is estimated at 0.2%, whilst prevalence of T1DM among patients with AD can be up to 14%. Residual adrenal function in patients with established AD may be present in up to 30% of cases but its clinical significance is not fully clear.Aims: To evaluate the prevalence of AD with preserved glucocorticoid function in patients with T1DM at Newcastle Diabet...

Introduction: Pseudohypoparathyroidism (PHP) is a rare cause of hypocalcaemia due to parathyroid hormone (PTH) resistance in the proximal renal tubules. In contrast to PHP type 1A, PHP type 1B is characterised by the absence of the characteristic skeletal abnormalities and is transmitted in an autosomal dominant manner, but in the maternal line. Patients may have resistance to the action of other G-protein signaling hormones, like thyroid stimulating hormone (TSH).<p class...

A 48-year-old male presented with headache, cough and recurrent nose bleeds. Clinical examination showed saddle shape nose deformity. His past medical history included primary hypothyroidism diagnosed at the age of 10 years, was taking levothyroxine. His brother had a Rathke’s cleft cyst, surgically removed. His blood test were as follows: Sodium 125mmol/l, TSH 0.10mU/l, free T4 10.2pmol/l, freeT3 2.6pmol/l, cortisol < 28nmol/l, prolactin 240mU/l, FSH 1.8U/l, LH 0.3U/...

A 45-year-old female presented with secondary amenorrhea. Since menarche, her period has been irregular, which she initially managed with oral pills, which were discontinued in 2009. Subsequently, she does have complete secondary amenorrhoea. She has hirsutism at the age of 20. Which was initially well controlled with oral contraceptive pills but has been getting worse over the years. Ferriman-Gallwey’s score was high. She also stated that her weight had been steadily inc...

Background: Neonatal diabetes is an exceedingly rare condition, defined by the presence of persistent hyperglycaemia in the first months of life. It is sub-categorised into transient neonatal diabetes mellitus (TNDM) which resolves early and permanent neonatal diabetes mellitus (PNDM), which requires lifelong treatment. Transient neonatal diabetes is reported to have a global incidence of between 1/95 000–1/400 000 births. At present, there are less than 100 patients diag...

Case history: A 72 year old male was diagnosed with primary lung adenocarcinoma grade T4N2M1b with adrenal and brain metastasis 1 year previously. On diagnosis his tumour was strongly positive for PDL-1 expression. This patient was started on dexamethasone 8 mg once a day that was weaned down to 4mg twice daily and then slowly weaned off steroids whilst receiving whole brain radiation. He was started on pembrolizumab therapy and had received ten cycles of treatment when he beg...

Introduction: Androgens have long been known to play an important role in health and wellbeing. A range of clinical disorders in males and females can arise due to disruption to production and action of androgens. Androgen receptor (AR) is widely expressed throughout the adrenal cortex, yet the wider role for androgen signalling in the adrenal remains underexplored due to the lack of suitable animal models.Methods: An adrenal-specific androgen receptor k...

Background: Autoimmune Addison disease (AAD) is a rare but highly heritable endocrinopathy. The BACH2 protein plays a crucial role in T lymphocyte maturation, and in particular in regulatory T cell formation, and allelic variation in its gene has been associated with autoimmune conditions such as type 1 diabetes, autoimmune thyroid disease and vitiligo. Its role in susceptibility to autoimmune Addison’s disease (AAD) has not been investigated.Aim: T...

Background: Clinically significant Graves’ orbitopathy (GO) develops in 20% of those with Graves’ Disease (GD). Up to 90% of cases present at the same time as, or after, hyperthyroidism develops. Most cases of GD in the UK are managed in endocrinology clinics. Despite this, patients report significant delays before a correct diagnosis of GO is made. We argued that measures to increase awareness of the early signs of GO in those with GD and establishing a fast-track r...