Endocrine Abstracts

Context: Hyperthyroidism is a common endocrine condition that can be associated with significant morbidity. It is important to ascertain the underlying cause of hyperthyroidism as the natural history, potential complications and response to treatment can be very different.Objective: To investigate if measurement of TSH-receptor binding inhibitory immunoglobulin (TBII), a TSH-receptor antibody found in Graves disease, in the serum of newly diagnosed hyper...

Adrenal suppression and iatrogenic Cushing’s secondary to concomitant inhaled steroid and itraconazole is a potentially common and serious drug interaction. A 55 year old patient with bronchiectasis and asthma developed an exacerbation of allergic bronchopulmonary aspergillosis (ABPA). He had been on inhaled fluticasone for over 2 years. He was commenced on itraconazole. The patient was on holiday 6 weeks after itraconazole was commenced when he noted that his face had be...

The Northern Cancer Network Guidelines produced in 1999 for the management of differentiated thyroid cancer (DTC) state that patients should undergo two challenge scans after total thyroidectomy and radioiodine ablation; 6 months and 18 months after ablation. Due to the significant morbidity associated with thyroid hormone withdrawal in preparation for challenge scans, the need for the second scan has been questioned in the presence of a negative first scan and undetectable se...

Radioidine (RI) has been implicated as an adverse factor causing deterioration of Thyroid-Associated Ophthalmopathy (TAO). Oral steroids administered after RI appear to protect patients' eyes, and this practice is now widespread. Two factors may confound the controversy surrounding the effects of RI on TAO. Firstly hypothyroidism, which is common after RI and is independently detrimental to the eyes, and secondly studying patients who are in different phases of the natural his...

Phaeochromocytoma crisis is a rare life-threatening emergency and a diagnostic challenge.Over a 5 year period four patients (2 male, mean age of 38.5 years, range 29-51 years) presented to our intensive care unit with unexplained severe cardiopulmonary dysfunction. Other clinical features included pulmonary infiltrates (4/4), vomiting (3/4), palpitations (2/4), breathlessness (4/4), acute renal failure (2/4), fever (1/4) and abdominal discomfort (1/4). Hypertension was pre...

High dose intravenous methylprednisolone therapy is used in patients with severe thyroid-associated ophthalmopathy (TAO) and other inflammatory disorders. Although in the short-term it appears to be safe, the acute metabolic effects of this regimen have not been studied in detail.We studied 15 patients with severe TAO, aged 59 ± 10 (mean ± SD) years. One patient was known to have type 2 diabetes. Each patient received 500 mg of iv methyprednisolone daily on t...

Paragangliomas are rare tumours that arise from extra-adrenal chromaffin cells within the sympathetic paraganglionic axis. While neoplasms of the adrenal medulla, (phaeochromocytomas) are normally characterized by catecholamine (CA) hypersecretion, paragangliomas can be nonfunctional. We report our findings from 5 patients (4 males, 1 female) with paragangliomas. In 4 out of 5 patients the initial presentation was related to the space-occupying effect of the tumour. Episodic s...

The performance of a commercial method (RSR) for measuring TBII was compared prospectively with an in-house method. TBII data were correlated with clinical information available at the time of clinic attendance and with the ultimate diagnosis in the light of additional independent information (isotope scan, thyroid microsomal antibodies, response to treatment). Serum samples were collected prospectively from subjects attending an endocrine clinic and from normal subjects (grou...

A 68-year-old lady presented with a right-sided breast lump detected on routine mammography. Past medical history included type 2 diabetes, asthma, and hypothyroidism following radioactive iodine for toxic multinodular goitre. Staging CT showed 2 presumed metastases in the left lung, and one in the right lung. She was referred for biopsy and/or resection of these lesions. Histology of the left lower lobe lesion showed a typical carcinoid tumour with an adjacent neuroendocrine ...

Objectives: The aim of the study was to evaluate the normal reference values for thyroid uptake using Technetium-99 m (Tc-99 m) pertechnetate.Methods: Sixty-seven euthyroid patients with primary hyperparathydism who underwent parathyroid imaging with Tc-99 m pertechnetate between January 2012 to April 2014 at the Nuclear Medicine department, Newcastle upon Tyne Hospitals was studied. Electronic medical records and biochemical thyroid functi...