Endocrine Abstracts

Background and Aims: Recent studies have suggested that maternal thyroid dysfunction, particularly in early pregnancy, may have a detrimental effect on the neuropsychological development of offspring. In the light of these studies a local guideline was drawn which recommended screening thyroid function at booking in all pregnant women with a personal or family history of thyroid disease. The aims of this study were to assess adherence to this guideline, and to test its efficac...

Background: MEN2A-causing RET variants are considered highly penetrant, and early prophylactic thyroidectomy is recommended to prevent the development of Medullary thyroid cancer (MTC). However, existing risk estimates may be exaggerated due to their reliance on clinically selected patients, leading to unnecessary surgeries. To address this, we conducted a comprehensive study of 450,000 clinically unselected individuals to evaluate the risk of MTC wit...

We describe a 68 year lady who was found to have bilateral adrenal masses (7 cm on the right side and 1.3 cm on the left) during investigations for gastrointestinal symptoms, in early 2016. Biochemistry revealed high urinary normetanephrines of 41.7pmol/24h (ref 0–3) and metanephrines of 40pmol/24h (ref 0–1.8). A PET and MIBG scan revealed uptake in both adrenals and therefore a diagnosis of bilateral phaeochromocytoma was made. The patient had complained of occasion...

Introduction: Iodine is important for thyroid hormone synthesis, and iodine deficiency in pregnancy may impair foetal neurological development. Perchlorate, found in some foods and everyday chemicals (e.g. fertilisers) and thiocyanate, which is found in cigarette smoke, decrease the transport of iodine from the circulation to the thyroid cells by inhibiting the sodium-iodide symporter. Environmental exposure to these substances during pregnancy may result in reduced thyroid ho...

Introduction: Iodine is important for thyroid hormone synthesis, and iodine deficiency in pregnancy may impair foetal neurological development. Perchlorate, found in some foods and everyday chemicals (e.g. fertilisers) and thiocyanate, which is found in cigarette smoke, decrease the transport of iodine from the circulation to the thyroid cells by inhibiting the sodium-iodide symporter. Environmental exposure to these substances during pregnancy may result in reduced thyroid ho...

Background: Clinically significant Graves’ orbitopathy (GO) develops in 20% of those with Graves’ Disease (GD). Up to 90% of cases present at the same time as, or after, hyperthyroidism develops. Most cases of GD in the UK are managed in endocrinology clinics. Despite this, patients report significant delays before a correct diagnosis of GO is made. We argued that measures to increase awareness of the early signs of GO in those with GD and establishing a fast-track r...

Introduction: There remains considerable debate over combination T4/T3 therapy for thyroid hormone replacement. Whilst large randomised-controlled studies have failed to show benefit over T4 only, there remain patients who feel better on the combination. Animal studies suggest that up to 80% of intracellular T3 in the brain is derived from circulating T4 by local deiodination. We hypothesized that in patients on thyroxine ...

Aim: To audit the management and treatment outcomes of patients with acromegaly at Royal Devon and Exeter Hospital.Patients and methods: Hospital case records of 43 patients (21 male), presenting between 1982 and 2004 were reviewed retrospectively. Age at presentation ranged from 21 years to 77 years, with average follow-up being 11.2 years.Results: 9 (29 percent) of 31 patients had microadenomas at presentation while 22 (71 percen...

Background and aims: Maternal subclinical hypothyroidism during early pregnancy has been shown to be associated with impaired neuropsyhological developement of children.Recent consensus guidelines have recmmended aggressive case finding for thyroid or other autoimmune disorders.We have examined the efficacy of these criteria in identifying women with thyroid dysfunction during early pregnancy.Subjects and methods:During july 2002 to june 2003,we propecti...

Nonautoimmune hyperthyroidism (NAH) inherited as an autosomal dominant trait can result from activating germline mutations in the thyrotropin receptor (TSHR) gene. Clinical features described include nonremitting thyrotoxicosis, absence of the features of autoimmune thyrotoxicosis, advanced bone age and increased growth velocity. We report a family with a heterozygous germline mutation of the TSHR gene resulting in the substitution of serine (AGC) by asparagine (AAC) at codon ...