Endocrine Abstracts

Background: TSH receptor antibody (TRAb) measurement, with a sensitivity of >97% and specificity of 100%, is considered the gold standard investigation for diagnosing Graves’ disease (GD).Aim: To evaluate clinical diagnosis of GD or non- GD hyperthyroidism at a University Teaching Hospital compared to TRAb result.Methods: Electronic records of patients who had a TRAb measurement between December 2009 and October 2015 were ...

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Background: Adrenal incidentalomas (AI) are a common radiological finding (estimated prevalence 4%). Guidelines from the American Association of Clinical Endocrinologists (AACE) and the American Association of Endocrine Surgeons (AAES) recommend radiological evaluation at 3–6 months then annually for 1–2 years, and hormonal evaluation by measurement of plasma aldosterone/renin (ARR) activity, 24 h catecholamines/metanephrines (CATS), and 1 mg overnight dexamethasone ...

Background, case-history: Hypercalcaemia secondary to parathyroid hormone (PTH) independent mechanisms is well known, with differentials including Sarcoidosis. We describe a case of Sarcoid Myositis presenting with symptomatic hypercalcaemia (adjusted serum calcium levels of 3.12 mmol/l) but no muscle weakness in a 39-year-old lady with a background of Type 1 Diabetes Mellitus, Hyperthyroidism, and Rheumatoid Arthritis.Investigations: Laboratory investig...

A 58 year-old Polish lady was admitted to hospital after having had two tonic-clonic seizures. She reported a previous history of seizures but had been seizure-free for 10 years. In addition, she reported a 20 year history of hand spasms and perioral paraesthesia. As part of the investigation for seizures while she was living in Poland 10 years ago, CT head had shown bilateral basal ganglia calcification and on this basis she had been diagnosed with Fahr...

A 58 year-old Polish lady was admitted to hospital after having had two tonic-clonic seizures. She reported a previous history of seizures but had been seizure-free for 10 years. In addition, she reported a 20 year history of hand spasms and perioral paraesthesia. As part of the investigation for seizures while she was living in Poland 10 years ago, CT head had shown bilateral basal ganglia calcification and on this basis she had been diagnosed with Fahr...

Rare causes of severe androgen excess (AE) can present a diagnostic challenge to endocrinologists. Imaging may not identify occult ovarian pathology, and the detection of adrenal nodular disease may be indicative of incidental pathology. GnRH analogues can be used both as a medical treatment and as a diagnostic utility to confirm ovarian source, particularly in women with a preferential elevation of serum testosterone (T). In this case series, we present three cases highlighti...

Background: The short Synacthen test (SST) is used primarily to diagnose adrenal insufficiency (AI), with hyponatraemia being among the commonest indications. Given the national shortage of tetracosactide and following cases of test mismanagement highlighted by our Biochemistry department, we investigated the indications, appropriate patient selection and performance of this test.Methods: A retrospective analysis of 117 cases identified to have a SST per...

Introduction: Following the recent publication of The Endocrine Society Clinical Practice guideline for Congenital Adrenal Hyperplasia (CAH), we performed an evaluation of the service provided for adults with CAH to assess how well we are meeting the guideline standard and to make recommendations for service improvement.Methods: We performed an audit of adults with CAH under the care of the University Hospitals of Leicester. We undertook a cross-sectiona...

Introduction: Primary skeletal muscle lymphomas are extremely rare, accounting for less than 1% of extra-nodal lymphomas.1 Hypercalcaemia is a common reason for admission to hospital. There are four main mechanisms by which neoplasms can cause hypercalcaemia; secretion of parathyroid hormone-related peptide, osteolytic metastases, (rarely) ectopic PTH secretion, and expression of 1 alpha hydroxylase, causing excess activated vitamin D and gastrointestinal absorption...