Endocrine Abstracts

A 37-year-old female referred by gynaecologist with elevated serum testosterone found on evaluation for amenorrhoea. She has had oligomenorrhoea for 5 years with induced bleed on Logynon and no change on stopping. Episodes of feeling hot and sweaty and going red in face. On examination: weight 68 kg, BMI 25 kg/m2, euthyroid, euadrenal, no hirsutism. BP: 116/86 (lying) & 110/90 (standing for 2 min). Available blood results: Estradiol- 43–91; LH- <0.1&#15...

A 48-year-old healthy, normotensive male was referred by GP due to incidental finding of hypokalaemia of 2.5 mmol/L on routine blood testing. The patient was initially treated with oral potassium supplements with little effect. Biochemical investigations in the endocrine clinic demonstrated mild metabolic alkalosis, eunatraemia, mild hypomagnesaemia 0.6 mmol/L and hypercalcaemia of 2.84 mmol/L with hypophosphataemia of 0.53 mmol/L. PTH was high at 350 ng/L. Renin and aldostero...

Papillary microcarcinoma (PMC) of thyroid is being increasingly detected following thyroid surgery for various reasons. The management of incidental PMC, not clinically or radiologically evident, is not well defined often leading to over treatment. Identifying risk factors for recurrence could help in administering appropriate management.Aims and methods: To review the incidence of PMC and management locally. Retrospective review of case notes of patient...

A 66-year-old HIV positive male presented to gastroeneterologist with a 2 months history of severe fatigue, weight loss, dizziness and nausea. He had background of ulcerative colitis which was quiescent and he has not received steroids for more than 12 months. Baseline blood results revealed normal biochemistry with mild normocytic anaemia, neutropaenia and lymphopaenia. As there was a high clinical suspicion of adrenal insufficiency, the short synacthen test was performed whi...

Background: Thyroid fine needle aspiration cytology (FNAC) is an essential component of investigating discrete thyroid nodules. Grade THY3 Cytology implies a follicular lesion and usually requires diagnostic Hemithyroidectomy. Published data from UK suggests an incidence of malignancy in the range of 25 to 28% following Thy3 cytology. Nodular size of > 40 mm is shown to be significantly associated with increased incidence of thyroid malignancy. Aim: To assess the biochemic...

A 50 year old lady was referred with a two year history of recurrent spontaneous hypoglycaemic episodes. She had put on a stone in weight over this time period. She was otherwise fit and well and took no regular medications. She had a past medical history of treated melanoma. None of her family members had diabetes mellitus. Neither she nor her husband worked in a healthcare setting but her daughter was a district nurse. Prior to referral, she had a normal short synacthen test...

Primary Aldosteronism (PA) is caused by autonomous aldosterone production from the adrenal cortex (due to hyperplasia, adenoma or rarely carcinoma) and diagnosis is confirmed by elevated plasma aldosterone level with suppressed renin activity and localized further by CT scan of the adrenal glands and selective adrenal venous sampling (AVS) if required. On the other hand, Addison disease (also known as primary adrenal insufficiency) which represents the other face of the coin i...

This audit investigated the utilization of thyroid peroxidase antibodies testing in our trust. TPOAb, which emerges as a response to thyroid injury, is found in up to 27% of the population and is associated with autoimmune thyroid disorders. However, it is not considered a disease-causing factor or transmitted from mother to fetus. TPOAb is commonly requested in the community. The retrospective audit reviewed 282 requests from the adult service to the laboratory. After excludi...

Introduction: Non-diabetic hypoglycaemia (NDH) has many causes including insulinoma, non-insulin producing cancers and gastric bypass surgery but medications like fluoxetine are rarely reported.Case history: 55 years female, university lecturer, history of Roux-en-Y gastric bypass in 2015 and depression, referred for recurrent symptomatic hypoglycaemia 1 to 2 hours post-meal (reactive hypoglycaemia) with recorded capillary blood glucose up to 1.6 mmol/l ...

A 32-year-old gentleman, of South-Asian origin was admitted with a 4-week history of abdominal pain, nausea and vomiting. He also had history of polyuria, polydipsia and weight loss over 6 weeks. Just prior to these symptoms he had been started on colecalciferol 20 000 units weekly by his GP for Vitamin D deficiency (25(OH) Vitamin D – 10.3 nmol/l (48–145)). On admission he had adjusted calcium of 4.52 mmol/l and acute kidney injury with his eGFR being 38 ml/min per ...