Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular risk, which may relate to enhanced sympathetic nervous system (SNS) activation. The cerebral pathways involved in this process are not known.Aims: i) To compare SNS activation in response to isometric forearm contraction (IFC) in patients with PCOS and controls. ii) To identify and compare the neuronal signatures of this response.Methods: 15 ...

The National Paediatric Diabetes Audit (NPDA) has now been established for 9 years and collects data on standards of care as defined by the National Institute for Clinical Excellence (NICE). These include demographics of paediatric diabetes, care process completion rates and outcomes.Since April 2011 the NPDA has been managed by the Royal College of Paediatrics and Child Health (RCPCH) which comprises a project board advised by specific working groups as...

Cardiac contractility, electrophysiology and energy metabolism are markedly dependent on the level of circulating thyroid hormone. Some of the effects are secondary to changes in heart rate and systemic blood pressure, but most genes involved in the effects on cardiac function are transcriptionally regulated by T3. Knock-out models in which expression of the various T3-receptors (TR) was manipulated indicate a principal role of TRα, although signalli...

Introduction: Diabetic Ketoacidosis (DKA) is a life threatening complication of type 1 diabetes mellitus (T1DM) in children. An integrated care pathway (ICP) for management of DKA based on guidelines published by the British Society for Paediatric Endocrinology and Diabetes has been established in Wales with the 2nd edition published in May 2010.Aims: To audit the management of DKA in a teaching hospital following the introduction of the second edition o...

Case: A 62-year old man with a previous diagnosis of asymptomatic subclinical hypothyroidism (TSH: 13.6 mU/L, FT4: 23 pmol/L) and elevated TPO antibody titres (>600 IU/ml) was referred with persistently elevated TSH levels despite increments in the dose of thyroxine. Thyroid function test (TFT) on 200 mcg of thyroxine showed an elevated TSH (13.0 mu/L) and FT4 (31.1 pmol/L). Thyroxine was gradually reduced and stopped. Following this, although FT4 levels normalised (20.7 p...

Introduction: Despite 50 years of treating CAH with steroids, clinical practice still varies considerably. In 2002 a consensus statement provided ‘best practice’ guidelines for the management of the condition. In South Wales CAH is managed by an Endocrine Network. A service evaluation was performed to obtain parents views on their experience.Methods: Thirty-one patients with CAH were identified. A questionnaire was designed using the consensus ...

Introduction: The UK Newborn Screening Programme provide guidelines which facilitate diagnosis and treatment of congenital hypothyroidism (CHT). Prompt treatment is important to ensure normal growth and development. This audit examines initial findings and growth over the first 2 years of life in CHT associated with agenesis, ectopia or dyshormonogenesis of the gland.Methods: Patients were identified from the University Hospital of Wales paediatric endoc...

Introduction: Children with type 1 diabetes mellitus (T1DM) are at increased risk of being overweight. Being overweight could be related to insulin requirements, female gender, and duration of diabetes. The aim of this study is to examine the Body Mass Index (BMI) of children and young people with T1DM at the Children’s Hospital for Wales and explore co-factors that may contribute to risk.Methods: A retrospective review of all patients with T1DM att...

A 49-year-old lady was referred by her GP with lethargy, oligomenorrhoea and persistent hypertension despite three anti-hypertensives (lisinopril, amlodipine, and atenolol). She denied exogenous steroid usage and had no other medical history.On examination, she had features of Cushing’s syndrome including plethora, moon face, central obesity and androgenisation of her facial skin. She weighed 98 kg.Overnight (1 mg) low dose de...

Case Report: A lady of 43 presented with an insidious onset of weight loss, lethargy, muscle pains, and more recently; polydipsia, nausea and vomiting. She had been recently started on levothyroxine for primary hypothyroidism. She was hypotensive and tachycardic. Investigations revealed Sodium 123 mmol/L (133–146), Potassium 5.0 mmol/L (3.5–5.3), Urea 16.2 mmol/L (2.5–7.8), Creatinine 153 umol/L (45–90) and calcium 3.4 mmol/L (2.1–2.6). PTH was <0....