Endocrine Abstracts

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...

Background: Salivary biomarkers are attractive diagnostic tools for paediatric practice, enabling non-invasive sampling at home. Salivary cortisol (SCl) and cortisone (SCn) are sensitive markers of adrenal insufficiency during inhaled corticosteroid treatment(1). SCn is reported to be the best correlate of plasma cortisol. Measurements of SCl may not be necessary, reducing cost and sample volumes.Eleven beta hydroxysteroid dehydrogenase type 2...

We present a case of 39y old male who underwent adrenalectomy and aortic lymph node dissection for neuroendocrine tumour in context of underlying VHL disease and previous adrenalectomy. Iatrogenic injury to his duodenum resulted in prolonged, multiple intraabdominal infections and development of enterocutaneous fistula. He had to remain NBM, relied on high dose iv hydrocortisone administration and TPN feed for several months. Conversion back to oral steroids was considered unr...

Background: Insulin dose requirements are higher during puberty and in overweight/obese individuals with type 1 diabetes mellitus (T1DM) due to insulin resistance. Through meta-analysis metformin has been shown to be beneficial as adjunctive therapy in T1DM adults independent of BMI. The large volumes of insulin required to administer higher insulin doses in insulin-resistant individuals have adverse effects on insulin absorption. Insulin degludec (Tresiba) U200 preparation al...

Introduction: We present a series of 10 cases of GD presenting with seemingly unrelated symptoms with limited features of thyrotoxicosis, where control of thyroid function tests (TFTs) led to complete normalisation of presenting symptoms. In all cases patients were shown to have Graves disease with thyroid antibodies.Case series review: 1. 82F with symptomatic hypercalcaemia and thymic hyperplasia on CT. Calcium normalised with standard therapy and remai...

Background: Up to 50% of children treated with inhaled corticosteroids (ICS) have biochemical evidence of adrenal insufficiency (AI). Episodes of adrenal crisis (AC) are extremely rare.To address the discordance between the prevalence of biochemical AI and AC, we re-examined the biochemical definition of AI during ICS therapy. We then investigated the utility of early morning salivary cortisol (EMSC) and cortisone (EMSCn) for the identification of patien...

Introduction: Ischaemic heart disease occurs seven times more frequently in women with Turner syndrome (TS) than the normal population. Adult TS subjects have raised serum cholesterol (Ch). In our service we measure Ch, apolipoprotein A1 (APA) and B (APB) annually in TS patients aged >5 years as APB:APA in childhood is a strong predictor of cardiovascular risk in adult life. Little is known about lipid profiles or the effects of GH or oestrogen (E2) in childhood...

Hyperthyroidism is common and in iodine-sufficient parts of the world the prevalence of overt hyperthyroidism is estimated to be 0.2% to 1.3%. The treatment options include antithyroid medication (ATD), thyroid surgery, or Radioactive iodine (RAI). The latter is increasingly used as a first line definitive treatment for hyperthyroidism. We reviewed the outcomes of patients who received RAI at our tertiary nuclear medicine department over a 4-year period (May 2015 to Dec 2019) ...

Introduction: Impairment of the hypothalamic–pituitary–adrenal (HPA) axis has been reported widely in children treated with inhaled corticosteroids (ICS). The integrity of HPA axis has been assessed using low (500 ng/1.73 m2 body surface area) and standard (250 mg) dose short synacthen tests (SST). Serum cortisol is measured at 0, 15, 20, 25, 30 and 35 min intervals in the low dose SST (LDSST) and at 0, 30 and 60 min in the standard dose SST (SDSST). The L...

Background: The activity of the hypothalamic–pituitary–adrenal axis (HPA) during inhaled corticosteroid (ICS) treatment of asthma has been studied extensively. To date patient populations have been too small or homogeneous to identify relationships between steroid exposure, patient characteristics and HPA activity. In this abstract we report data from a large, heterogeneous cohort of patients recruited to observational and pharmacogenomic studies.<p class="abstex...