Endocrinology

The Edinburgh Centre for Endocrinology and Diabetes (ECED): Endocrinology

Endocrinology is a specialty that encompasses diverse conditions so it is difficult to provide comprehensive referral advice.  The guidance which follows is intended to address common scenarios.  If in doubt, all endocrine consultants welcome requests for advice as well as referrals. Paediatric endocrinology at the Royal Hospital for Children & Young People (RHC&YP) provides specialist services for children and young people across the South East Scotland region.   Paediatric endocrinology routinely accepts referrals up to the age of 16 years; and up to 18 years if the referral relates to pubertal delay, issues regarding growth or absent vaginal bleeding. 

Services

The ECED team provide general endocrine clinics at the following sites:

• Royal Infirmary of Edinburgh (RIE)
• Western General Hospital, Edinburgh (WGH)
• St John’s Hospital, Livingston (SJH)
  
  There is also a monthly clinic at East Lothian Community Hospital where patients from East Lothian requiring ongoing Endocrine review can be seen. It is generally best, however, if new patients are seen first at either the RIE or WGH, where a much greater range of investigations is available. They can subsequently be transferred to the ELCH clinic for review if appropriate.
  
  A multidisciplinary clinic for patients with thyroid nodules is run weekly at RIE endocrinology and endocrine surgery.  All euthyroid patients in Edinburgh with a thyroid nodule or goitre should be referred to this service using the Thyroid Nodule Clinic option on SCI Gateway. In West Lothian, referrals may be made to Mr Gavin Browning’s surgical clinic at SJH.  Children under the age of 16 should be referred to the endocrinology clinic at the Royal Hospital for Children and Young People (RHCYP).
  
  Professor Richard Anderson and Prof Colin Duncan run a reproductive endocrinology clinic at RIE, with endocrine input from Prof Rebecca Reynolds and some patients will be more suitable for this service than for general endocrinology, as highlighted subsequently.
  
  A weekly multidisciplinary clinic for patients with thyroid eye disease is run at the Princess Alexandra Eye Pavilion (PAEP) by endocrinology, in conjunction with Dr Justin McKee (ophthalmology).  Patients with active dysthyroid eye disease are seen jointly in this clinic. Entry to the joint clinic is arranged via referral to PAEP and not via endocrinology.
  
  

A bi-monthly multidisciplinary clinic for patients with neuro-endocrine tumours (NETs) is run at WGH by Prof Mark Strachan and Dr Stuart Ritchie (endocrinology) and Dr Lucy Wall (oncology).  Only patients with confirmed NETs attend this clinic.  Patients who are suspected to have a NET should be referred to the general endocrine service in the first instance.

A monthly multidisciplinary Endocrine-Genetic clinic for patients with Genetic Endocrine syndromes requiring active complex screening/genetic counselling is run by Prof Mary Porteous and Dr Roger Brown. This particularly involves the diagnosis and follow-up of von Hippel-Lindau syndrome and other disorders having familial phaeochromocytomas/ paragangliomas. Only those with such confirmed Genetic-Endocrine disorders regularly attend this clinic. Those suspected of having such disorders, almost always with confirmed component features, can be referred for evaluation and consideration of genetic testing to general Clinical Genetics, whilst those with suspicion of endocrine disorders should be referred to the general Endocrine service in the first instance.