Endocrine Abstracts

Case history: A 35-year-old female presented to a district general hospital with convulsive status epilepticus. In the two weeks preceding the seizure, she complained of migrainous-type headaches, transient aphasia and ataxia. Her general practitioner organised a confusion screen, revealing hypothyroidism and commenced levothyroxine 50 μg. She had no other medical history and denied illicit drug use or alcohol-excess. Examination revealed mild pyrexia (38.2°C), clonu...

Case history: A 45-year-old female with a background of depression presented with asthma exacerbation. She was taking paroxetine and mirtazapine for depression. Over the preceding six months the patient’s asthma control had deteriorated, resulting in overuse of inhaled beclometasone. On questioning, the patient reported a four stone weight gain in four months with generalised weakness, dizziness and fatigue during simple activities. On examination, the patient appeared ov...

A 57 year-old gentleman with uncomplicated Type 2 Diabetes Mellitus and 30 pack year smoking history was assessed in outpatient endocrinology clinic with a 4 month history of non-specific symptoms, including dizziness, lack of energy and intermittent bi-frontal headaches described as ‘pressure behind the eyes’. There was no history of exogenous steroid use. Bloods at 0833 h identified deficiency in testosterone (<1 nmol/l; N= 6–30 nmol/l), thyroxine...

In recent years there has been significant progress in defining the genetic aetiology of neonatal diabetes with disease-causing variants identified in over 30 genes. These genes are all recognised as having a critical role in the development, function, or destruction of the pancreatic beta-cell. Targeted next generation sequencing allows for the rapid, simultaneous screening of all 30 known neonatal diabetes genes. This analysis provides an accurate genetic diagnosis for over ...

The proximate cause of functional hypothalamic amenorrhea (FHA) is reversible suppression of GnRH drive that results in chronic anovulation and low estradiol levels that preclude endometrial growth and shedding. Clinical management of FHA requires not only understanding the neuromodulation of GnRH drive, but also how cognitive and behavioral concomitants suppress GnRH drive. FHA results in a constellation of neuroendocrine concomitants that include activation of the hypothalam...

Gynaecomastia is the proliferation of the male breast glandular tissue and should be distinguished from lipomastia (weight-related fat deposition, also known as pseudogynaecomastia). The development of subareolar ductular tissue and fibrosis in gynaecomastia produces a firmer consistency compared to adipose tissue, which can be differentiated on examination. Gynaecomastia is common and can affect up to two-thirds of adult men. Typically, gynaecomastia arises from an imbalance ...

Iodine is an essential component of thyroid hormones that are required for brain development. Severe iodine deficiency during pregnancy can result in cognitive impairment and lower IQ in the offspring. However, the effects of mild-to-moderate iodine deficiency on brain development and neurocognitive function are less well known, and this is important as mild-to-moderate deficiency is common in pregnancy in many European countries, including the UK. There are recommendations in...

Over the last 20 years, the phenomenon of type 2 diabetes in childhood has been increasingly recognised. National Audit data shows that in the UK there remains a relatively low prevalence of childhood type 2 diabetes, whilst the incidence has increased sharply in other parts of the world.This presentation aims to cover the pathogenesis of type 2 diabetes, its presentation, investigation, diagnosis and management, with a discussion of some of the newer tr...

Introduction: It was recognised there was a need to improve the current diabetes service provision at a District General Hospital in Yorkshire to meet the payment by results (PBR) best practice tariff. This tariff is based on recommendations by NICE, the Department for Health and the regional tertiary centre.Objective: The main change to be implemented by this district general hospital was the creation of a 24 h diabetes service staffed by trained profes...

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