Endocrine Abstracts

Background: Multiple Endocrine Neoplasia (MEN1) is an autosomal dominant disorder characterised by tumours of the parathyroids, pancreas and pituitary. Recent consensus guidelines have recommended screening of MEN1 gene mutations in patients who have at least two of the parathyroid hyperplasia, pancreatic endocrine tumour or pituitary adenoma, or are suspicious of having MEN1 (multiple parathyroid tumours before age 30, recurrent hyperparathyroidism, gastrinoma or multiple isl...

Graves' disease, which is characterised by thyrotoxicosis and a diffuse goitre, is an autoimmune disease caused by thyroid-stimulating antibodies. The onset of Graves' disease whilst a patient is on immunosuppressive treatment is unexpected and remains a rarity.A 37-year-old Caucasian female presented to the thyroid clinic with a two week history of sweating, nausea, tremor, heat intolerance and palpitations. She was known to suffer from severe pustular ...

Background: Accurate diagnosis of an underlying cause of thyrotoxicosis is critical for targeted therapy. Thyroid radionuclide uptake scan is a useful second line investigation in patients who lack TSH receptor antibody. The uptake scan patterns identify patients who can be preferentially treated with anti-thyroid drugs (diffuse pattern - Graves’ disease) or radio-iodine treatment (patchy uptake - multinodular or localised uptake – toxic adenoma) or simple monitoring...

Introduction: A breech presentation occurs in 3–5% of all full-term pregnancies and is associated with increased risk of maternal and foetal morbidity. Factors known to increase the risk of breech presentation include prematurity, low birth weight and multiple pregnancies. Recent studies suggest maternal thyroid hormone deficiency in late pregnancy may also be a risk factor. Our study aims to assess if a breech presentation at 36 weeks gestation in a healthy singleton coh...

Background: Subclinical hypothyroidism is common in pregnancy affecting about 5% of all pregnant women, and is associated with adverse pregnancy outcomes. There is a general consensus that subclinical hypothyroidism detected during pregnancy should be treated with L-thyroxine (Stagnaro-green et al. 2011, DeGroot et al. 2012). However, it is unclear whether the treatment should be limited only during the pregnancy or continued long-term. Therefo...

Background: Maternal thyrotoxicosis affects 0.2% of pregnancies. Pharmacological treatments include carbimazole, methimazole and propylthiouracil. The Endocrine Society recommends the use of propylthiouracil as first line during pregnancy, because of possible associations between carbimazole and congenital anomalies. However, recent reports link propylthiouracil to liver injury in adults, children, pregnant women and fetuses, raising questions over its safety.<p class="abs...

Introduction: Thyroid eye disease (TED) is a chronic disorder with a potential to cause facial disfigurement and visual impairment. Recent surveys of clinicians have shown variability and deficits in the management of TED. The European Group on Graves’ Orbitopathy (EUGOGO) recently published guidelines on the management of TED, recommending that all patients with TED should be referred to specialist multi-disciplinary TED clinics. We aimed to study the patients’ expe...

A 63-year-old lady was admitted with a 10 day history of central abdominal pain associated with constipation and vomiting. She was diagnosed with myelodyplasia 11 years previously and required regular blood transfusions but was otherwise fit and well. On this presentation, she was apyrexial with a heart rate of 72 beats per minute and blood pressure of 170/74. Her abdomen was soft with mild periumbilical tenderness. Routine blood investigations showed haemoglobin of 10.2 g/dl ...

Introduction: Thyroid Eye Disease (TED) affects quality of life causing a negative impact on psychosocial life. Previous findings identifed the phenomenon of an altered sense of identity with associated lowered-self esteem, social withdrawal and isolation. How this ‘altered identity’ influences interactions with Healthcare Professionals (HCPs) has not been investigated.Study aim: To explore the nature of interactions between HCPs and patients w...

Background: Multiple endocrine neoplasia (MEN) type 2B is an autosomal dominant condition characterised by aggressive medullary C cell tumours, phaeochromocytoma and a discrete physical appearance. A specific point mutation in the RET proto-oncogene is present in 95% cases; prophylactic thyroidectomy is recommended in the mutation carriers. Occasionally cases present with the characteristic physical appearance of MEN2B but no identifiable germline mutation or endocrinop...