Endocrine Abstracts

Background: A diagnosis of Addison’s disease means lifelong dependence on daily glucocorticoid and mineralocorticoid therapy and is associated with increased morbidity and mortality, as well as a risk of unexpected adrenal crisis. We wished to explore whether immunomodulatory therapy at an early stage of autoimmune Addison’s disease could lead to preservation or improvement in adrenal steroidogenic function.Design: We conducted an open-label, p...

Hyperthyroidism is associated with increased thrombotic risk through mechanisms that are not fully understood. In contrast, a tendency to bleeding has been reported in hypothyroidism. Fibrin network structure has been shown to determine susceptibility to atherothrombosis and venous thrombotic events and therefore, this study investigates the effects of thyroid-dysfunction on clot structure and fibrinolysis using longitudinal interventional studies.Sevent...

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...

Maternal nutrient restriction at specific gestational stages compromises fetal growth and development, in particular, fetal adipose tissue deposition. The extent to which nutritional supplementation can promote growth and development of specific fetal organs is unknown. This study aimed to determine whether protein supplementation of the maternal diet at defined stages of gestation promoted the abundance of the key mitochondrial proteins; uncoupling protein 1 (UCP1), cytochrom...

In patients with autoimmune Addison’s disease (AAD), exogenous glucocorticoid (GC) therapy is an imperfect substitute for physiological GC secretion; patients on long-term steroid replacement have increased morbidity, reduced life expectancy and poorer quality of life. Recent early-phase studieshave demonstrated that some endogenous steroidogenic function – Residual Adrenal Function (RAF) - is maintained at the point of diagnosis in a proportion of AAD patients; this...

Non-functioning pituitary adenomas (NFPAs) are the commonest subtype of pituitary tumour. Surgical resection, accompanied by radiotherapy (RTX) in selected cases, is the treatment of choice for compressive tumours. Long-term health consequences of treatment for NFPAs are unclear. In this retrospective study, we assessed long-term pituitary function and mortality rates in a large NFPA cohort across two tertiary centres in the UK and Ireland.Case-note revi...

Despite lifelong glucocorticoid and mineralocorticoid replacement, there is excess morbidity and mortality associated with autoimmune Addison’s disease (AAD). Adrenal cortical cells undergo continuous self-renewal from a population of subcapsular progenitor or stem cells, under the influence of ACTH. We aimed to determine if synthetic ACTH analogue could revive adrenal steroidogenic function and ameliorate AAD.We performed an open-label trial of syn...

Objective: Remission rates in young people with Graves’ hyperthyroidism are <25% after a 2-yr course of thionamide antithyroid drug (ATD). Immunomodulatory agents might improve outcome by facilitating immune tolerance. We explored whether rituximab (RTX) would increase remission rates when administered with a short course of ATD.Design: This was an open label multi-centre single arm phase 2 trial in newly presenting young people (12-20y) with Gr...