Endocrine Abstracts

A 39-year-old female was referred to the emergency department with a sore throat, fever, myalgia and odynophagia. She had presented to her GP three months previously with palpitations, erratic mood and fatigue and had been diagnosed with hyperthyroidism. She had been started on carbimazole 20 mg od and was awaiting review in endocrinology OPD. She had no other past medical history and was a non-smoker. On examination she was tachycardic with a heart rate of 113. She had cervic...

A phaeochromocytoma is a catecholamine secreting tumour arising from the adrenal medulla and a paraganglioma refers to its extra adrenal counterpart, which can develop from sympathetic or parasympathetic tissue anywhere from the skull base to the pelvis. Presenting symptoms of these rare tumours are most commonly related to catecholamine excess, and include headache, palpitations, paroxysmal hypertension, anxiety, abdominal pain and excessive sweating. A phaeochromocytoma cris...

Testosterone deficiency syndrome (TDS) may well contribute to a number of co morbidities and multitude of symptoms which may affect one’s daily activities adversely. TDS prevalence in UK is 1:500 and certain groups of patient’s are at higher risk of TDS, in particular elderly and patients with diabetes mellitus where 42% are known to have TDS. A retrospective audit was carried out to bench mark our practice in line with a publication of a recommended National/Europea...

This is an unusual case of sleep apnoea treated with C-PAP as a result of multinodular goitre (MNG) which was overlooked.This is a case of a 69-year-old gentleman who was referred to the endocrine clinic for assessment of his diabetes. Sleep apnoea was diagnosed around four years ago and he has been using C-PAP every night. Enlargement of multinodular goitre coincided with the diagnosis of sleep apnoea. He has previously been seen by another endocrinolog...

It is paramount to educate our patients, thereby empowering them to manage their chronic conditions. This is an evidence based fact. As healthcare professionals our challenge is to provide and ensure patients have been well informed in order to understand and manage their condition successfully on a daily basis.In today’s healthcare service patient education has become a casualty of the reduced resources; there are ever increasing restrictions on bo...

We report three patients who were referred for possible chronic fatigue syndrome and presented with a long standing history of a multitude of symptoms. Comprehensive investigations revealed a low IGF1 and subsequent insulin tolerance test (ITT) demonstrated growth-hormone (GH) deficiency with a normal MRI pituitary in each case. The first patient presented at the age of 34 years with lethargy, aches and difficulty concentrating. Biochemically the only abnormality in th]e basal...

We report a case of a female patient who initially presented aged 35 yr with shortness of breath and type 2 respiratory failure at 12 weeks of her pregnancy. She was previously known to have a multinodular goitre under another hospital, which had been stable for several years, and had no other medical problems. Clinically and biochemically she was euthyroid (free T4 12.6 pmol/L [11.0–23.3], TSH 0.42 mu/L) and there were no signs of obstruction. An ultrasound scan showed a...

Testosterone deficiency syndrome (TDS) may well contribute to a number of co-morbidities and multitude of symptoms which may affect one’s daily activities adversely. TDS prevalence in UK is 5:1000 and certain groups of patient’s are at higher risk of TDS, in particular elderly and patients with diabetes mellitus where 42% are known to have TDS. A retrospective audit was carried out to bench mark our practice in line with a publication of a recommended National/Europe...

Background: Growth hormone (GH) stimulation testing is necessary for the diagnosis of growth hormone deficiency (GHD). Insulin tolerance test (ITT) has been considered the gold standard for evaluating GHD in adults. However, it carries a risk of rare but severe adverse effects secondary to hypoglycaemia and is therefore avoided in many centres. There is no consensus for the first test in children.Aim: Audit to compare ITT to Arginine test as a first line...

A 30 year old woman presented with two year history of right lower leg pain. The pain was constant, worse in cold weather, not worsened by weight bearing and occasionally woke her from sleep. On examination she was tender on palpation of mid distal right tibia. X ray showed sclerotic portions of right tibia and fibula. MR lower right leg demonstrated extensive area of intramedullary bone marrow oedema in the distal half of the right tibia with associated cortical thickening an...