Clinical Endocrinology最新文献

{"title":"Hashimoto's Thyroiditis Beyond Thyroid Hormones: A Systematic Review of Autoimmunity, Inflammation, and Multidimensional Burden","authors":"Gaspare Alfì,&nbsp;Valerio Caruso,&nbsp;Giovanna Grenno,&nbsp;Angelo Gemignani,&nbsp;Alessandro Antonelli,&nbsp;Poupak Fallahi,&nbsp;Silvia Martina Ferrari","doi":"10.1111/cen.70114","DOIUrl":"10.1111/cen.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hashimoto's thyroiditis (HT) is the most common autoimmune thyroid disease. Although levothyroxine therapy effectively normalizes thyroid-stimulating hormone (TSH) in most patients, persistent symptoms are frequently reported, suggesting that autoimmunity and inflammation contribute to reduced quality of life (QoL) independently of thyroid hormone levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>According to PRISMA guidelines, we systematically searched for MEDLINE, Scopus, and Web of Science studies that assessed the association of thyroid autoimmunity, inflammatory markers, and QoL in adults with HT. Included designs were observational, interventional, and longitudinal studies that published qualified QoL outcomes and immune/inflammatory markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across diverse study designs, HT patients—typically euthyroid or receiving long-term levothyroxine therapy—consistently reported lower QoL compared with controls, particularly in cognitive, affective, and vitality domains. Elevated anti-thyroid antibodies (anti-TPO, anti-Tg) were negatively correlated with QoL, whereas TSH and thyroid hormone levels showed no consistent association. Interventional studies demonstrated that total thyroidectomy or therapies associated with reduced antibody titers were accompanied by improvements in fatigue and QoL. However, an important caveat must be emphasized. Some studies did not confirm a direct association between antibody levels and symptom severity, likely reflecting methodological variability and heterogeneity in QoL assessment tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is evidence that HT exerts a multidimensional impact beyond endocrine dysfunction, with chronic autoimmunity and low-grade inflammation contributing to impaired QoL. These findings should be taken into account and perhaps challenge a purely TSH-centric model and call for a broader, patient-centered approach that integrates immunological, psychological, and subjective outcomes. Properly designed longitudinal and interventional trials are required to establish causal pathways and support the personalization of therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"3-13"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes Following Supply-Driven Transition From Intranasal to Oral Desmopressin in AVP-Deficiency—A Single Centre Experience Including The Pituitary Foundation Desmopressin Shortage Impact Report","authors":"Trevor Tam,&nbsp;Amy Mach,&nbsp;Alam Wahid,&nbsp;Neetha Joseph,&nbsp;Amy Shingler,&nbsp;Patricia McBride,&nbsp;Francesca Swords,&nbsp;Ketan Dhatariya,&nbsp;Rupa Ahluwalia","doi":"10.1111/cen.70120","DOIUrl":"10.1111/cen.70120","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Arginine vasopressin deficiency (AVP-D) requires lifelong desmopressin replacement. In March 2025, the national suspension of intranasal desmopressin necessitated urgent transition to oral alternatives. However, optimal conversion ratios and clinical response remain undefined. We evaluated clinical outcomes following this supply-driven transition.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A retrospective study at a tertiary UK centre (01/01/2025–01/07/2025) identified patients with confirmed AVP-D switched from intranasal to oral desmopressin. Demographic and clinical data were collected. Conversion ratios (intranasal: oral) were calculated before and after titration.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Forty two patients were included (mean age 52.6 ± 2.3; 31% male). 15/42 (35.7%) isolated AVP-D; 11/42 (26.2%) partial hypopituitarism; 16/42 (38.1%) panhypopituitarism. Median intranasal desmopressin dose pre-switch was 10 mcg/day (IQR 10–20 mcg). Initial median oral dose before titration was 200 mcg/day (IQR 100–200 mcg); final median oral dose after titration was 200 mcg/day (IQR 162.5–300 mcg). 23/42 (54.8%) were switched initially using 1:10 ratio (10 mcg intranasal desmopressin to 100 mcg oral tablet). 13/23 (56.5%) reported symptomatic recurrence, warranting further titration. The remaining 19/42 (45.2%) were switched initially using a median ratio of 1:20 (IQR 1:11.8–1:20). 10/19 (52.6%) reported symptomatic recurrence. Overall, switching from intranasal to oral desmopressin resulted in 16 patient calls, 79 additional blood tests and one hospitalisation. Similarly, the findings of The Pituitary Foundation Impact Report demonstrated that the switch led to 121/161 (75.2%) of patients reporting poorer symptomatic control post-switch, and 76/161 (47.2%) requiring additional endocrine input.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;45.2% (19/42) of patients achieved adequate symptom control post-switch with varying conversion ratios, and over half (13/23, 56.5%) of patients switched with an initial 1:10 conversion ratio reported symptomatic recurrence. Although a higher initial conversion ratio closer to 1:15 may reduce symptomatic recurrence in some patients, initiating treatment at a 1:10 ratio with careful up-titration represents a safe and pragmatic approach that minimises the risk of over-replacement and hyponatraemia, although inter-patient variability necessitates tailored titration. In parallel, national patient-reported data from The Pituitary Foundation Impact Report demonstrate the substantial patient and clinical burden of this supply-driven switch, highl","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"66-76"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamics of Apolipoprotein J Levels and Metabolic Parameters Following Bariatric Surgery","authors":"Kellen Cristina da Cruz Rodrigues,&nbsp;Minjin Lee,&nbsp;Yejee Lim,&nbsp;Jennie Young,&nbsp;Brendon Chung,&nbsp;Susan Phillips,&nbsp;Theodore P. Ciaraldi,&nbsp;Young-Bum Kim","doi":"10.1111/cen.70087","DOIUrl":"10.1111/cen.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Bariatric surgery has emerged as a potent intervention for ameliorating insulin resistance and its associated comorbidities in obese patients. Apolipoprotein J (ApoJ) and adiponectin are closely associated with insulin resistance and sensitivity, respectively. While changes in adiponectin levels following surgically induced weight loss have been intensively investigated, the response of ApoJ and its impact on metabolic parameters following bariatric surgery remain unclear. We aimed to elucidate serial changes in ApoJ levels and their associations with responses of adiponectin levels and critical metabolic parameters after Roux-en-Y gastric bypass (RYGB) surgery. Seven obese patients undergoing RYGB surgery were enrolled in this prospective study. Clinical and laboratory data were collected before surgery and at multiple time points from 1 day up to 12 months post-surgery. Serum levels of ApoJ, total adiponectin, and its multimeric forms, along with anthropomorphic and other metabolic parameters, were measured in the fasting state.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Post-surgery, marked improvements were observed in anthropometric measures, and in serum levels of glucose, insulin, leptin, GLP-1, adiponectin, and homeostatic model assessment of insulin resistance (HOMA-IR) and insulin secretion (HOMA-ß). While ApoJ levels remained relatively stable, a positive association was seen with changes in leptin levels (r² = 0.499, <i>p</i> = 0.024); no association was found with changes in adiponectin levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that although overall ApoJ levels did not change significantly, individual temporal variations were associated with changes in leptin levels, indicating that ApoJ may serve as a potential biomarker after RYGB. Larger studies are needed to validate these observations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"42-50"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145803321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Radioactive Iodine Therapy on Cancer-Specific Survival of Papillary Thyroid Carcinoma With T4aM0 Stage","authors":"Pengyu Li,&nbsp;Yao Tong,&nbsp;Yujie Zhang,&nbsp;Yuanyuan Fan,&nbsp;Guang Yang,&nbsp;Wanjun Zhao,&nbsp;Tao Wei,&nbsp;Xiaofei Wang","doi":"10.1111/cen.70123","DOIUrl":"10.1111/cen.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Papillary thyroid carcinoma (PTC) with T4aM0 stage, which involves extrathyroidal extension without distant metastasis, presents challenges in treatment management. While radioactive iodine (RAI) therapy has been shown to benefit certain high-risk thyroid cancer patients, its effect on cancer-specific survival (CSS) in T4aM0 PTC patients remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aim to evaluate the impact of RAI therapy on CSS in T4aM0 PTC patients following total thyroidectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>1938 PTC patients with T4aM0 stage who underwent total thyroidectomy in the SEER database were identified. Clinical-pathological and CSS data were systematically collected. Patients were stratified into the RAI-treated group and the non-RAI-treated group. Propensity score matching (PSM) was implemented with 1:1 nearest-neighbour matching to balance baseline covariates. Intergroup comparisons of demographic and clinical characteristics were performed in the entire cohort and PSM cohort. Subset analyses were conducted to indicate the effect of RAI therapy on CSS in different subgroups. Cox proportional hazards regression models were employed to evaluate CSS outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After PSM, 472 pairs of patients were included in the analysis. In both the entire cohort and the PSM cohort, no significant difference in CSS was observed between RAI-treated and non-RAI-treated patients (HR = 0.797, 95% CI: 0.540–1.175, <i>p</i> = 0.252; HR = 0.709, 95% CI: 0.437–1.151, <i>p</i> = 0.709). Subgroup analysis also showed no survival benefit of RAI across various clinical characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RAI therapy does not significantly improve cancer-specific survival in T4aM0 PTC patients after total thyroidectomy. These findings suggest that RAI may not be necessary for this subgroup, advocating for more individualised treatment approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"93-99"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Failure Predictors in Thyroid Nodule Radiofrequency Ablation Using Multivariate Analysis: A Single-Centre Experience","authors":"Shmuel Wechsler,&nbsp;Tanya Shcherbaeva,&nbsp;Jacob Pitaro,&nbsp;Limor Muallem Kalmovich","doi":"10.1111/cen.70125","DOIUrl":"10.1111/cen.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Radiofrequency ablation (RFA) has become an established minimally invasive treatment for benign thyroid nodules (BTN), offering excellent safety and efficacy. However, factors predicting treatment success and post-procedural thyroid dysfunction remain incompletely understood. This study aimed to perform a preliminary evaluation of clinical, procedural, and biochemical predictors of RFA outcomes in a real-world consecutive patient cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design and Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on consecutive patients who underwent ultrasound-guided RFA for cytologically benign thyroid nodules between January 2018 and March 2024 at a single tertiary medical centre. Demographic, sonographic, procedural, and biochemical variables, including thyroid-stimulating hormone (TSH), thyroglobulin (Tg), and anti-Tg antibodies, were analysed. The primary endpoint was the Volume Reduction Ratio (VRR), with ≥ 50% defined as procedural success.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-two patients (mean age 52.6 years; 85.5% female) were included. The median best VRR achieved was 61.9% (IQR 46.6–74.5), with 71% of patients attaining ≥ 50% reduction. Higher pre-treatment Tg levels were significantly associated with reduced VRR (<i>p</i> &lt; 0.001) and remained independently associated with procedural failure in an exploratory multivariable model (OR 0.87 per 10 ng/mL increase, <i>p</i> = 0.011). Pretreatment TSH levels showed a univariate positive trend but did not reach statistical significance on multivariate analysis. Two patients (3.2%) developed hypothyroidism post-RFA, both with positive anti-Tg antibodies (total 13 patients had positive anti Tg Ab). The overall complication rate was 6.5%, with no major adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results suggest that pre-treatment thyroglobulin levels may serve as a potential biochemical predictor of RFA success in benign thyroid nodules, while antibody positivity may suggest susceptibility to post-ablation hypothyroidism. While most existing literature focuses on imaging features (e.g., sonographic features) or surgeon technique, our findings highlight the unique importance of biochemical characteristics. Incorporating biochemical profiling into pre-procedural assessment could refine patient selection and enhance individualised treatment planning. Future prospective studies are warranted to validate Tg as a biomarker of RFA response.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"85-92"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Incidental and Non-Incidental Papillary Thyroid Microcarcinoma Outcomes: Implications on Management Recommendations","authors":"Emma A. Finnegan,&nbsp;Justin M. Hintze,&nbsp;Anne McGowan,&nbsp;James Gibney,&nbsp;Conall W. R. Fitzgerald,&nbsp;John Kinsella,&nbsp;Marie Louise Healy","doi":"10.1111/cen.70127","DOIUrl":"10.1111/cen.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Papillary thyroid microcarcinomas (PTMC) are defined by the World Health Organisation (WHO) as tumours measuring ≤ 10 mm. Incidental PTMCs, or lesions discovered postoperatively on histological examination, are less extensively studied compared with lesions diagnosed preoperatively through cytology, particularly in terms of demographics, histopathological features and long-term outcomes. This study aimed to compare outcomes between these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-centre retrospective cohort analysis of data from the St. James's University Hospital Head and Neck tumour board spanning from 2013 to 2023 was conducted. A total of 152 patients diagnosed with PTMCs and neck nodes ≤ 1 cm were identified during this period. Of these, 55 were incidental and 47 were non-incidental PTMCs included in the final analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant differences were observed between the two subgroups in terms of the size of the largest tumour focus (7.8 mm vs. 3.9 mm, <i>p</i> &lt; 0.001), the presence of aggressive histologic variants (9.2% vs. 0.9%, <i>p</i> = 0.002) and the frequency of neck dissections (8.8% vs. 0.0%, <i>p</i> &lt; 0.001). However, no recurrences occurred in either group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This comprehensive 10-year retrospective review found few differences in the presentation of incidental and non-incidental microcarcinoma, with low recurrence rates and excellent outcomes. These findings, with overall low numbers, provide hypothesis-generating evidence that this group may be suitable for discharge to primary care for further follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"100-107"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Single Centre Study to Describe the Changes in Serum Testosterone Concentration Following Application of Testosterone Gel in Post-Menopausal Women With Hypoactive Sexual Desire Disorder (HSSD) Already Receiving This as Part of Usual Care in Conjunction With Oestrogen-Containing Hormone Replacement Treatment (HRT)","authors":"Adrian Heald,&nbsp;Yasitha Illangasekera,&nbsp;Hassan Rehman,&nbsp;Mark Livingston,&nbsp;Anne Keen,&nbsp;Rupinder Kochhar,&nbsp;Nicholas Panay,&nbsp;Joanna Borzomato,&nbsp;Mathilde Mordaunt,&nbsp;Peter Taylor,&nbsp;Geoff Hackett","doi":"10.1111/cen.70119","DOIUrl":"10.1111/cen.70119","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Hypoactive Sexual Desire Disorder (HSDD) is characterized by a long-term decrease in sexual desire (low-libido) causing personal distress. HSDD predominantly affects post-menopausal women or following oophorectomy. Despite the clear indication that testosterone action could overcome the symptoms of HSDD by elevating testosterone levels, there is little research concerning this. For decades many post-menopausal women have been prescribed off-label testosterone, an approved therapy for men, at a modified dose. The purpose of this study was to conduct an exploratory pharmacokinetic analysis in post-menopausal women with low sexual desire consistent with HSDD already established on treatment with Testosterone gel (Testogel 16.2 mg/g Gel in Pump, Besins Healthcare (UK) Ltd.).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Twenty-four women applying Testogel 16.2 mg/g via pump once every 3 or 4 days and had been prescribed Testogel 16.2 mg/g for at least 6 months were included. All were additionally taking oestrogen-based hormone replacement therapy (HRT). They attended for a testosterone day curve with Testogel 16.2 mg/g at the dose of 20.25 mg applied after an initial blood test. Samples were taken 2-hourly for 10 h and at 24 h post-Testogel 16.2 mg/g application. Testosterone was measured by mass spectrometry. The Female Sexual Functioning Index (FSFI) was completed by the women. Pharmacokinetic parameters of maximum concentration (Cmax), average concentration (Cavg), time to Cmax (Tmax), Area under curve (AUC) and half-life (t&lt;sub&gt;1/2&lt;/sub&gt;) were determined with and without adjustment for baseline testosterone.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Mean age of the women was 53.7 ± 6.8 years, and the mean BMI was 27.4 ± 4.3 kg/m&lt;sup&gt;2&lt;/sup&gt;. Mean blood pressure was 126/75 mmHg. The unadjusted median Cmax testosterone concentration was 6.25 nmol/L (range 1.3−26.1), and Cavg was 4.51 nmol/L (range 0.93−20.21). AUC testosterone varied substantially from 35.9 to 458 nmol.h/L (median 121.8). The baseline-adjusted median Cmax was 3.55 nmol/L and the Cavg was 1.64 nmol/L. There was considerable variability between individuals in both measured Cmax in testosterone through the day (1.3−26.1 nmol/L) The AUC testosterone ranged from 39.45 to 181.8 nmol.h/L. FSFI median score was 26.5/36 (25%−75% interquartile range 18−30) with the highest domain scores for sexual satisfaction and arousal (4.2/6) and slightly lower scores for orgasm and desire (4.0/6), and no reported issues regarding pain on intercourse. All women subjectively reported an improvement in sexual function with Testogel 16.2 mg/g. No symptoms of hyper","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"77-84"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Classical Presentations of Rare Hereditary Hypoparathyroidism: A Case Series of CASR, GNA11 and GATA3 Mutations","authors":"Ekaterina Bibik,&nbsp;Kamila Meirambek,&nbsp;Rustam Salimkhanov,&nbsp;Anna Eremkina,&nbsp;Sergey Popov,&nbsp;Ekaterina Dobreva,&nbsp;Marina Yukina,&nbsp;Ekaterina Troshina,&nbsp;Natalia Mokrysheva","doi":"10.1111/cen.70141","DOIUrl":"10.1111/cen.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hereditary hypoparathyroidism (hypoPT) is a rare endocrine disorder caused by absent or insufficient parathyroid hormone (PTH) secretion. Genetic forms are uncommon and frequently underdiagnosed, particularly when clinical onset is atypical.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>We present a case series of three patients with genetic hypoPT caused by <i>CASR</i>, <i>GNA11</i> and <i>GATA3</i> mutations, highlighting atypical clinical presentation, diagnostic challenges and management approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical data, biochemical results, and genetic findings were analysed in a case of three female patients with early-onset, nonsurgical hypoPT, focusing on presentation patterns, diagnostic pathways, and choice of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All patients exhibited chronic hypocalcemia, hyperphosphatemia, and low PTH without prior neck surgery, but had non-classical features leading to delayed diagnosis. Genetic testing identified pathogenic variants associated with autosomal dominant hypocalcemia types 1, 2, and Barakat syndrome. Age at symptom onset ranged from childhood to adolescence, whereas diagnosis was established only in late adolescence or adulthood. Major complications included intracranial calcifications (all cases), cataracts, and renal impairment. Initial presentations mimicked neurological, dermatological, and renal disorders, contributing to diagnostic delay. All patients required individualised therapy and multidisciplinary follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Genetic causes of hypoPT should be suspected in patients with early-onset or atypical presentations in the absence of neck surgery. This case series illustrates that timely genetic testing confirms the diagnosis and determines personalised therapy. Management requires careful titration of calcium, active vitamin D medication to avoid complications and may benefit from emerging treatments (long-acting PTH analogues). Early recognition and tailored interventions can improve patient outcomes and quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"116-121"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graves' Disease: Prospective Up to 10-Year Outcome for 100 Consecutive Individuals at a Single Centre","authors":"Muhammad Muneeb Ibad,&nbsp;Mrinalini Srichandran,&nbsp;Sangeeth Veluchamy,&nbsp;Waseem Majeed,&nbsp;Natalie Gallant,&nbsp;Sarah Jamil,&nbsp;Rupinder Kochhar,&nbsp;Suhani Bahl,&nbsp;Lakdasa Premawardhana,&nbsp;Peter Taylor,&nbsp;Onyebuchi Okosieme,&nbsp;Colin Dayan,&nbsp;Adrian Heald","doi":"10.1111/cen.70148","DOIUrl":"10.1111/cen.70148","url":null,"abstract":"&lt;p&gt;Graves' disease is named after Robert J. Graves, who described the condition in 1835 [&lt;span&gt;1&lt;/span&gt;]. The prevalence of Graves' disease is approximately 1% in the population as a whole: the incidence is 20–30 new cases/100,000/year [&lt;span&gt;2&lt;/span&gt;]. Both genetic and environment factors, such as familial clustering, negative life experiences, high iodine intake, and smoking, predispose to Graves' disease being clinically manifest [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Graves' disease remains a challenging condition to manage in the 21st Century, with no new pharmacotherapies for many years. However, new options for treatment utilising immunotherapy approaches have potential [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In order to study the trends of thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free liothyronine (FT3) with Graves' disease, we undertook an evaluation of outcomes for 100 people diagnosed with Graves' disease, for up to a 10-year period after diagnosis. We also organised the data into different groups according to biographical status and what therapy the individual underwent. All individuals were seen in the endocrinology outpatient clinic as consecutive presentations at a single centre in the United Kingdom.&lt;/p&gt;&lt;p&gt;Individuals were first seen between 2012 and 2014. The Electronic Patient Record (EPR) was accessed to collect data which was then collated in a Microsoft Excel spreadsheet. Biographic data (age and gender) were recorded. The results for those who underwent thyroid surgery, received radioactive iodine treatment, diagnosis of thyroid eye disease, together with deaths and relapses, were compiled. Patients remained under the care of the Endocrinology Clinic, and data were gathered through the clinical follow-up.&lt;/p&gt;&lt;p&gt;For up to 10 years, data were collected for TSH, FT4, and FT3 levels at baseline (0 month), 3, 6, 12 months, as well as 2, 5, and 10 years. The data were collected at Outpatient Clinic appointments in the endocrinology centre. Follow-up was ascertained through the local electronic patient record. Outcomes were reported at approximately 10 years from initial assessment where available, or otherwise at the most recent documented follow-up within the local healthcare system.&lt;/p&gt;&lt;p&gt;Not all patients had tests done at these specific intervals. Patients were mostly still resident within the catchment area throughout the follow-up period, but some were lost to follow-up, mostly due to non-attendance at outpatient appointments.&lt;/p&gt;&lt;p&gt;TSH receptor antibody (TSHRAb) levels were also recorded along with any recheck of TSHRAb levels. FT4, FT3, and TSH were measured on the Siemens Atellica Immunoassay platform (Manchester, UK) with TSHRAb measured on the Dynex DS2 2-Plate ELISA Processing System (Chantilly, USA).&lt;/p&gt;&lt;p&gt;Continuous variables were summarised as mean (standard deviation) or median (interquartile range), and categorical variables as counts and percentages. Kernel density plots were used to display the distribution of FT4 values at","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"122-125"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Challenges in Transition to Adult Care for Young People With Endocrinopathies","authors":"Margaret Zacharin,&nbsp;Quynh-Nhu Nguyen","doi":"10.1111/cen.70118","DOIUrl":"10.1111/cen.70118","url":null,"abstract":"<p>The complexity of transition of pediatric patients to adult care is well recognized, with a multidisciplinary approach widely agreed to be essential. Despite extensive existing literature in this area, practical guidance as to the management of specific medical aspects and how to address these with patients and families is lacking, with little accessible literature to help guide practitioners. Many paediatric endocrine conditions have a genetic or epigenetic aetiology. Both presentation and evolution of their specific health issues may be unfamiliar to adult endocrinologists, few of whom have experience and expertise in both paediatric and adult domains. This paper aims to address these knowledge gaps and provide guidance for the transition of patients with childhood-onset endocrine disorders, delineates management strategies for both the paediatric and adult clinicians, and highlights areas that may be unfamiliar in adult practice.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"14-21"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}