Endocrine Abstracts

Context: Approximately 10% of patients on levothyroxine remain symptomatic despite restoration of biochemical euthyroidism. Some therefore utilise alternatives to levothyroxine monotherapy including combination thyroid hormone replacement, T3 monotherapy and desiccated thyroid extract (DTE). We examined thyroid hormone profiles in these patients.Methods: We examined 49 individuals 14 on combination thyroid hormone replac...

Levothyroxine, the standard therapy for hypothyroidism, is usually well tolerated and very few cases of true allergy to levothyroxine have been reported to date. In these cases mechanisms have not been conclusively identified but have been hypothesized to be allergies to excipients. Here we report a rare occurrence of levothyroxine allergy and the effectiveness of desensitization. A 56-year-old lady with no previous history of allergies required a total thyroidectomy for Grave...

Background: Neuroendocrine tumours (NETs) are heterogeneous cancers with varied survival, arising mainly from the gastroenteropancreatic tract. Delayed diagnosis and mislabelling are widely recognised internationally in midgut NETs with little data describing how to improve diagnosis times. In 2017, transformation of the South Wales NET Service included a change to a gastroenterology-led service model alongside education and forming working relationships with gastroenterologis...

Objective: Quantify classic and 11-oxygenated androgens in serum and saliva and determine variations across age, sex, body mass index (BMI), menstruation and hormonal contraception use.Methods: Morning serum samples were collected from 292 healthy volunteers (125 men, 22-95 years; 167 women, 21-91 years). Morning saliva was collected from 83 healthy volunteers (51 women, 32 men). 25 individuals (12 women, 13 men) also collected a 7-timepoint diurnal sali...

Background: Advancements in medical care have significantly improved survival after major traumatic injury and the main risks are now sepsis and multi-organ failure. An understanding of the hormonal, inflammatory and metabolic changes that occur following trauma is still evolving but it is clear that they impact significantly upon patient prognosis. To date, studies that have examined trauma-induced changes in steroid metabolism have analysed samples taken from patients post-h...

Vitamin D deficiency during pregnancy has been linked to adverse pregnancy outcomes such as pre-eclampsia (PET), but continues to be defined by serum measurement of a single metabolite, 25-hydroxyvitamin (25(OH)D). To identify broader changes in vitamin D metabolism during normal and PET pregnancies we developed a mathematical model using a reduced reaction network for vitamin D metabolism that allows for complete parametrisation by multiple vitamin ...

Background: Alemtuzumab (ALTZ) is a humanised monoclonal anti-CD52 antibody used as effective treatment for relapsing/remitting multiple sclerosis (MS), causing panlymphopenia with subsequent lymphocyte repopulation. Unfortunately, around 40% of patients develop secondary humoral autoimmunity, mainly affecting the thyroid gland. Anti-thyrotropin-receptor (TSHR) autoantibodies (TRAb) can stimulate (TSAb), block (TBAb) or not affect (‘neutral’) TSHR function, with TSAb...

Vitamin D deficiency during pregnancy has been linked to adverse pregnancy outcomes such as pre-eclampsia (PET), but continues to be defined by serum measurement of a single metabolite, 25-hydroxyvitamin (25(OH)D). To identify broader changes in vitamin D metabolism during normal and PET pregnancies we developed a mathematical model using a reduced reaction network for vitamin D metabolism that allows for complete parametrisation by multiple vitamin ...

Background: Alemtuzumab (ALTZ) is a humanised monoclonal anti-CD52 antibody used as effective treatment for relapsing/remitting multiple sclerosis (MS), causing panlymphopenia with subsequent lymphocyte repopulation. Unfortunately, around 40% of patients develop secondary humoral autoimmunity, mainly affecting the thyroid gland. Anti-thyrotropin-receptor (TSHR) autoantibodies (TRAb) can stimulate (TSAb), block (TBAb) or not affect (‘neutral’) TSHR function, with TSAb...

Case history: A previously well 45-year-old lady presented with a 3-year history of hypertension initially diagnosed at a routine health check. Her blood pressure (BP) was 170-180/90-100 mmHg.Investigations: Showed hypokalaemia (K+= 3 mmol/l; NR 3.5-5.3 mmol/l), raised aldosterone (976pmol/l; NR 100-500pmol/l) and supressed renin activity (<0.2nmol/l/h), meeting criteria for diagnosing primary aldosteronism (PA). CT adrenals showed a 2.5 cm left adre...