Endocrine Abstracts

Immunotherapies such as IL-2 and interferon have long been used in the treatment of certain cancers and immune mediated conditions. It has also long been recognised that their use is associated with an increased risk of autoimmune thyroid disease. Recent advances in the use of checkpoint inhibitors, such as ipilimumab and PD-1 inhibitors, in the treatment of a number of common cancers, as well as treatments such as alemtuzumab in multiple sclerosis have dramatically increased ...

Oral bisphosphonate therapy provides the usual first line approach to the treatment of osteoporosis and is associated with relative reduction in fracture risk of approximately 50% at the spine, 30% at the proximal femur and up to 20% at peripheral sites. Fracture risk reduction is maintained over 5 years of treatment and there are data confirming continued efficacy of treatment for up to 10 years in individuals at high fracture risk. Prolonged bisphosphonate treatment has, how...

‘Clinicians who have never missed the diagnosis of Cushing's syndrome or have never been fooled by attempting to establish its cause should refer their patients with suspected hypercortisolism to someone who has.’ This quote, by Professor James Findling, an expert in Cushing’s syndrome, is a reminder of the difficulties in diagnosing Cushing’s syndrome. These difficulties in part reflect the increasing incidence of obesity, hypertension and type 2 diabetes....

The presentation will start with a review of the relationship with autoimmune thyrotoxicosis and the white cell count. Pre-therapy measurements and on-going measures of checking for leucopenia will be discussed.The evidence for a temporal effect of the thionamides will be reviewed. This will detail the times for increased vigilance and appropriate standard advice for patients initiating thionamides. Dosing and different thionamides and their potential va...

Bartter and Gitelman syndromes are salt wasting alkaloses. These inherited conditions are the result of impairment of sodium chloride reabsorption in the loop of Henle (Bartter) or distal tubule (Gitelman). Secondary hyperaldosteronism occurs as a direct result of renal salt wasting resulting in hypokalaemia and metabolic alkalosis. The tubular defects seen mimic those of long-term loop (Bartter) or thiazide (Gitelman) diuretic use and urinary calcium levels and serum magnesiu...

Steroid-dependent individuals, in particular those with primary adrenal insufficiency, are a vulnerable patient group. They are prone to acute adrenal crisis which is a life-threatening medical emergency requiring immediate recognition and treatment. Among individuals with primary adrenal insufficiency, acute adrenal crisis has a frequency of 6–8 per 100 patient-years. Unfortunately, delays in diagnosis and management are common, constituting an avoidable source of patien...