Endocrine Abstracts

We present a case of a six year old boy with an enlarging thyroid mass. He was asymptomatic, euthyroid and had no family history of thyroid disease.Examination and neck ultrasound showed hard mass replacing left thyroid lobe with no lymphadenopathy. FNA cytology suggested diagnosis of lymphoepithelial cyst of the thyroid.Left hemithyroidectomy and isthmusectomy was performed. At operation no lymphadenopathy was seen and right thyro...

Background: Low thyroid hormone concentrations in the first few weeks of life in preterm infants may be linked with poor neurodevelopment. We conducted a multi-centred randomised controlled trial of thyroxine (T4) supplementation in babies born under 28-weeks’ gestation (TIPIT study). A post hoc subgroup analysis was undertaken to examine brain growth and development.Methods: Seventy-eight infants received T4 supplementation an...

Introduction:Hypothyroidism may be associated with bradycardia, low voltage complexes,ST-T wave changes, atrioventricular and intraventricular conduction disturbances. Extrasystoles and tachyarrhythmias of both atrial and ventricular origins have been described in hypothyroidism with the ventricular tachyarrhythmias associated with prolonged QT interval.Aims: To ascertain the prevalence of cardiac arrhythmias in primary hypothyroidism.<p class="abste...

We present the case of a 76 year old woman who was admitted to our hospital with severe Cushings syndrome, in association with hair loss and hypokalaemia. Plasma cortisol levels were elevated, and did not suppress with high dose dexamethasone. ACTH levels were detectable throughout the HDDST. MRI pituitary and CT adrenals were normal, but CT of chest revealed an area of nodularity in the right lung. With no specific treatment her symptoms settled, and her biochemistry returned...

Introduction: Myxedematous coma is a rare endocrine emergency that settles in the absence of appropriate treatment for hypothyroidism for a long period. The severe and chronic reduction of serum thyroid hormones culminates in the insufficiency of compensatory mechanisms that maintain the physiological homeostasis of the organism. The clinical condition is severe, commonly associated with hypoxemia, hypercapnia, hypothermia, reduced cardiac output, and altered mental status.</p...

Case history: Carbimazole, a widely used medication to treat hyperthyroidism, is associated with several well-established side effects. Carbimazole-induced lymphopenia is however rarely reported in the literature. This case focuses on a 57-year-old lady diagnosed with Graves’ Disease (GD) in 2015. She was started on Carbimazole which eventually stabilised her thyroid function; her severe thyroid eye disease precluded definitive treatment with radioiodine however she was r...

Introduction: Anti-TSH-receptor binding antibodies can cross the placenta and can stimulate or inhibit the fetal thyroid, causing fetal and neonatal thyroid dysfunction. We test for these antibodies in all pregnant women with a history of thyroid disease using a TSH binding inhibitor immunoglobulin (TBII) assay. Our aims were to audit our management of TBII positive pregnancies and to review pregnancy outcomes.Methods: Serum TBII concentration was measur...

Introduction: Prolonged therapy (≥ 3 months) with high-dose corticosteroids (≥ 7.5 mg Prednisolone or 1–1.5 mg Dexamethasone daily) can result in adrenal atrophy and secondary adrenal failure. Abrupt withdrawal of corticosteroids after prolonged use can lead to adrenal insufficiency, corticosteroid withdrawal symptoms or a relapse of the initial disease. A safe flexible management plan is required for each patient. We illustrate with two cases.<p class="ab...

Head and neck paragangliomas (HNPs) are tumors derived from the neuroectoderm. HNPs are generally hormonally silent and often asymptomatic. They can be part of the Pheochromocytoma/ Paraganglioma Syndrome, due to mutations of SDHB, SDHC and SDHD genes. SDHD founder effects have been described in the Netherland, USA, Italy and Spain.We identified a new founder effect in a small geographic area (Valsugana-Trentino, actually 50.000 inhabitants), with high a...

A 24 year old man was admitted by the Surgeons with left sided abdominal pain. He was febrile and tachycardic and found to have raised inflammatory markers. Abdominal CT scan revealed a 6 cm left adrenal haemorrhage with no evidence of an underlying lesion. Initial endocrine investigations were unremarkable for Cushings, Conn’s and adrenal insufficiency. Norepinephrine levels were high but settled subsequently. He had a coagulopathy and evidence of reactivation of EB viru...