Endocrine Abstracts

Subclinical hyperthyroidism is characterised by low serum TSH with normal free T4 and free T3. Subclinical hyperthyroidism may reflect Graves’ disease or toxic nodular hyperthyroidism, and is found in up to 5% of the over 60’s. In addition, about 20% of patients who are taking T4 therapy have low serum TSH, i.e. biochemical evidence for over-treatment. In those not prescribed T4 it is important to exclude other cause...

Primary hyperparathyroidism (PHP) is one of the most common endocrine diseases; it is frequently found in asymptomatic patients when there is some doubt as to the appropriate choice of surgery (PTX), medical therapy or watchful waiting. These decisions are generally based on the consensus guidelines produced by the NIH however there is concern that these reflect established medical/surgical practice in the USA as much as clinical evidence. What evidence that does exist is freq...

Endogenous hypercortisolism and chronic glucocorticoid (GC) therapy reduce bone mass, increase central fat mass, alter adipokines and enhance cardiovascular risk. Surgery (pituitary, adrenal or for ectopic ACTH) can control hypercortisolism in 90% of patients in experienced hands, and is often followed by inhibition of the adrenal axis, requiring substitution therapy with GC for months or years. We have been interested in learning on long-term outcome of ‘cured’ CS p...

Primary adrenal insufficiency is often a consequence of autoimmune destruction of the adrenal cortex. Mortality is increased primarily due to acute adrenal crises, especially among patients diagnosed at young age. In the long-term more than 50% of the patients will develop other autoimmune diseases or manifestations, particularly autoimmune thyroid disease. Despite seemingly adequate treatment, accumulating evidence document reduced subjective health status, particularly gener...