Endocrine Abstracts

Over the past two decades, the developed world has witnessed an epidemic of incidental thyroid nodules diagnosed through imaging of the neck for other indications. This has created new challenges for patients and clinicians. Several guidelines have been published in the past 2 years on this topic, which are broadly concordant and only differ in detail. Optimal management is based on the following principles: 1. Avoidance of imaging unless there is a clea...

Destructive thyroiditis is characterised by hyperthyroidism due to release of pre-formed hormones. The increased concentration of thyroid hormone suppresses serum TSH. Radioactive iodine uptake is close to nil in all cases when hyperthyroidism is present. The duration of hyperthyroidism is generally 2–3 months and limited by the amount of thyroid hormone present. The ratio of serum T3:T4 is lower in destructive thyroiditis than in Graves’ disease. Hypothyroidism is c...

The “sick euthyroid syndrome” or “non-thyroidal illness syndrome” (NTIS) occurs in a large proportion of hospitalized patients and comprises a variety of alterations in the hypothalamus-pituitary-thyroid (HPT) axis that are observed during illness. One of the hallmarks of NTIS is decreased plasma triiodothyronine (T3) levels, in severe illness accompanied by low plasma thyroxine (T4) and increased plasma reverse T3 (rT3) concentrations. Downregulation of hy...