Endocrine Abstracts

Introduction: Recent evidence supports the use of high dose steroids for 28 days in acute alcoholic hepatitis. We present a patient with Childs Pugh C liver cirrhosis, who developed adrenal axis suppression following such treatment. We discuss the complex aetiology and biochemistry of hypocortisolism in liver disease.Case: 48 year-old female admitted with alcoholic hepatitis, treated with a non-tapering 28-day course of 40 mg prednisolone. The patient wa...

Introduction: NICE guidelines recommend additional support is provided to CYP with a high HbA1c. Elective hospital admissions are one option for improving glycaemic control.Aims/objectives: To evaluate the implementation of, and impact on HbA1c of, planned admissions in CYP in our service.Methods: All planned admissions for management of sustained high HbA1c in patients with known ...

Background: Demeclocycline is a well-known treatment for syndrome of inappropriate ADH secretion (SIADH). We studied the use of demeclocycline for treatment of SIADH in our hospital to assess its efficacy and safety.Materials and methods: A search was performed for all discharge summaries containing demeclocycline over period of 1 year. 40 results obtained of which five were excluded as demeclocycline was mentioned but not actually used. 35 admission epi...

Introduction: Sodium-Glucose Co-Transporter-2 (SGLT2) inhibitors are the latest class of anti-hyperglycaemic agents which reduce blood glucose by increasing urinary glucose excretion.Aims: 1) To assess the metabolic and haemodynamic changes associated with SGLT-2 inhibitors in patients attending Sligo University Hospital (SUH) Ireland.2) To enhance prescriber awareness across disciplines regarding the metabolic and haemodynamic ben...

A 52 year old gentleman was referred for an inpatient Endocrinology review. He was admitted after incidental finding of severe hyponatremia of 119. He felt unwell after having an episode of vomiting at home a few days ago and then had his bloods done at primary care. He denied any headache, dizziness, or visual disturbance. Further investigations were requested which revealed plasma osm 247, urine osm 350, and urine sodium 132. A diagnosis of SIADH was established and he was p...

Introduction: Hyperthyroidism is a pathological state characterized by increased synthesis and secretion of thyroid hormones (thyroxine (T4) and triiodothyronine (T3)) by the thyroid gland. Subclinical hyperthyroidism – a milder form – is defined as a low or suppressed TSH (<0.4 mIU/l), but serum free T4 (FT4) and free T3 (FT3) within the reference interval.Case: 76 years old lady seen in endocrine clinic. She was referred by GP because of ...

Background: Postprandial hyperinsulinemic hypoglycaemia due to nesidioblastosis is a significant and debilitating complication after Roux-en-Y gastric bypass surgery (RYGB). There is growing evidence suggesting this is due to increased incretin hormones secretion. Nesidioblastosis can be difficult to manage with variable response to different pharmacological therapies and some requiring partial/total pancreatectomy or revision of bypass surgery pouch. We present a patient who ...

We present a case of 76-year-old male who attended acute medical unit with 3 week history of confusion, slurred speech and reduced mobility. One month prior to his admission he was diagnosed with severe hypothyroidism with TSH of 100 mU/l and T4 of 1.9 pmol/l and significantly positive anti-peroxidase antibodies (561 IU/ml) and was started on 100 μg of levothyroxine by his GP. During his admission his confusion persisted despite antibiotics for presumed chest i...

Introduction: Complete androgen insensitivity syndrome (CAIS) is an X-linked genetic disorder characterised by normal female appearance, including external genitalia and the presence of 46XY karyotype. We report a case of CAIS, diagnosed in adulthood, and discuss ethical issues surrounding the disclosure of diagnosis and associated difficulties in further management.Case history: A 33-year-old Nigerian lady was referred to our endocrine service with Prim...

Introduction: Phaeochromocytoma of the urinary bladder is a rare neoplasm and accounts for <1% of all phaeochromocytomas. It is more common in females and the majority of patients present in second and fourth decade. Its common presentation is painless haematuria, headache, palpitation, hypertension and syncope during or immediately after urination.Case history: We present a case of 48-year-old man who presented to Endocrinology with a few months his...