Endocrine Abstracts

Introduction: A 2009 BSPED survey revealed that 90% use a low dose Synacthen test (LDST) and 44% had noticed increased referrals of asthmatic children prescribed inhaled corticosteroids (ICS). Approximately 21% of UK children have asthma of whom 70% are prescribed ICS (10% at ‘high dose’). There is an increasing need for a simple, less invasive, alternative to the LDST to evaluate their adrenal function. We are developing a non-invasive LDST, with Synacthen administe...

A 61-year-old was diagnosed with CLL in 1986 but received no active treatment until 2006, when the WCC became elevated and bone marrow biopsy showed a dense B cell infiltrate. Despite initial treatment with chemotherapy there was disease progression, hence started on Alemtuzumab (Campath) on 24/5/2010. This was stopped on 18/6/2010 because of recurrent neutropenic sepsis. He was readmitted on 18/7/2010 because of left eye cellulitis and hyponatremic with serum sodium of 122 mm...

Liquid chromatography tandem mass spectrometry (LC–MS/MS) methods are considered superior to immunoassay for the analysis of serum 25-hydroxy vitamin D (25-OHD) due to improved performance and potential cost benefits. As LC–MS/MS is appropriate for the analysis of other clinically relevant hormones tandem mass spectrometers are becoming commonplace in UK clinical laboratories. However, like immunoassay, LC–MS/MS methods are not foolproof and inappropriate use of...

Growth hormone treatment (GHT) is used to improve height, and potentially quality of life (QOL), in children with abnormal growth patterns. Previous QOL research suggests children with acquired growth hormone deficiency (AGHD) benefit more from GHT than those treated for other conditions.The aim was to determine child and parent reported QOL change over 1 year depending on GHT and diagnosis.One hundred and twenty-two children (mean...

Background: Adrenal suppression is a well recognised complication of inhaled corticosteroids. Committee for Safety of Medicines (CSM) guidelines (2006) recommend that children taking high dose inhaled corticosteroids (HDICS) are tested for adrenal insufficiency. Patients requiring steroid replacement require a steroid card and written advice on steroid replacement in acute illness.Aims: To determine the impact of CSM guidelines on the use of short synact...

Hypopituitarism is associated with increased cardiovascular mortality. It has been suggested that hypogonadism, hypothyroidism, growth hormone deficiency (GHD), or indeed unphysiological hormone replacement regimens, might contribute to this excess cardiovascular risk. The adverse effect of hypercortisolaemia on insulin resistance, carbohydrate metabolism and hypertension is well recognised. It is also known that glucocorticoids adversely affect the coagulation-fibrinolytic sy...

Background: The National Institute for Clinical Excellence (NICE, 2002) suggests that measurement of quality of life (QOL) is necessary to assess the efficacy of GH treatment (GHT). A pilot study (Sheppard 2006) showed a greater improvement in QOL over the first 6 months of GHT for patients with acquired GH deficiency (AGHD) compared with idiopathic GH deficiency (IGHD).Method: In view of this, a longitudinal research study was set up to measure changes ...

There is a relative lack of data regarding the timing and in particular the severity of hypothyroidism post Radioiodine (RI). We retrospectively examined the timing and severity of hypothyroidism following RI in 213 patients, in relation to ‘target’ and actual follow up appointments, and the introduction of a nurse-led follow-up clinic. Hypothyroidism was defined as persistent elevation of TSH – mild (TSH 6.1–10 mU/l), moderate (TSH 10.1–50 mU/l) and s...

There are at least 60 reports of pregnancy and acromegaly. The maternal and foetal morbidity relates to associated diabetes mellitus and hypertension rather than maternal growth hormone excess. A 32-year-old Asian female who spoke no English, was noted to have acromegalic features during a hospital admission for pneumonia. She was 6 weeks pregnant and had been recently diagnosed with type 2 diabetes mellitus. Acromegaly was confirmed with GH nadir 105 mU/l during 75 g OGTT and...

Endocrinopathies are amongst the most common complications of thallasaemia, which is a hereditary disorder of haemoglobin synthesis and excessive iron deposition is thought to be the main reason.Our hospital serves a multiethnic population and consequently we see a substantial number of patients with thallasaemia who are screened for endocrine complications. Those found to have endocrine problems are reviewed in our joint thallasaemia-endocrine clinic. B...