Endocrine Abstracts

Vitamin D deficiency and osteomalacia continue to cause significant morbidity in Bradford. Outpatient attendance suggests this condition remains widespread. Poor awareness of this preventable and treatable condition exists. This audit was undertaken to highlight the frequency of normal biochemistry in patients with osteomalacia / vitamin D deficiency. Fifty-five patients (4M, 51F; 51 Asian, 4 Caucasian) were identified from our departmental computerised endocrine database. 25-...

A female presented in 1994 at age 28 with typical symptoms and signs of hyperthyroidism (FT4 39 picomol per litre, TSH < 0.05 milliunit per litre) and associated ophthalmopathy (bilateral exophthalmos, lid retraction and conjunctival inflammation), consistent with Graves' disease. Initially treated successfully with Carbimazole. She relapsed after stopping Carbimazole and in 1998 underwent sub-total thyroidectomy, with residual thyroid tissue left at the inferior poles bila...

The insulin stress test (IST) continues to be considered a potent test for assessing ACTH and GH reserve. The test has been shown to be safe when performed in an experienced unit. Many endocrine nurse specialists independently perform IST's using appropriate protocols. We audited all consecutive IST's performed by an individual endocrine specialist nurse in our unit. IST was not performed if patients had a history of seizure, ischaemic heart disease or were > 60 yrs. All pa...

Although treatment of osteomalacia is cheap and effective, there are few data on the long-term outcomes. Studies suggest that a minority of patients fail to normalise parathyroid hormone (PTH), due to autonomous parathyroid activity and primary hyperparathyroidism is sometimes 'unmasked' during therapy. This study examined the impact of a recommended oral regimen of calcium 1000 milligrams and vitamin D3 800 international units (20 micrograms) daily, on PTH levels. ...

We have previously shown that the current guidelines for monitoring thyroid function post radioiodine (RI), may not detect hypothyroidism until it has become severe, in a significant proportion of cases (J Endocrinol Invest 2012 35 82–86). An alternative more intense follow-up strategy was used whereby patients had TSH and FT4 measured at 4-week intervals post RI for 6 months. Endocrine specialist nurse-led telephone and nurse-led out-...

We present two cases where, without measurement of cortisol binding globulin (CBG), interpretation of their 250mcg short synacthen test (SST) would have falsely suggested inadequate pituitary-adrenal reserve.A 62yr old woman was referred with an incidental finding of a pituitary adenoma. Pituitary function tests confirmed gonadotrophin and growth hormone deficiency. Initial and subsequent SSTs were normal (30min cortisol reater than 600nmol/L). Follow up...

Tumoural GH secretion in acromegaly is characterised by increased non-pulsatile (basal) release, pulse amplitude and pulse frequency. We have studied the effect of primary therapy with Sandostatin LAR on GH pulsatility in 9 patients with acromegaly who achieved disease control (mean serum GH<2ug/L) on therapy (7 males; median (range) age 67 (43-75). Data obtained were compared with 16 healthy subjects (10 males, age 50 (30-75)). Spontaneous 24-h GH secretion (20 minute samp...