Endocrine Abstracts

A 44-year-old woman with a history of Bartters syndrome wanted a second opinion. Her height was 1.54 m, weight 69 kg, waist circumference 102 cm, BP 112/74. A OGTT was arranged because of her waist circumference. Fasting glucose 8.9 mmol/l, 2-hour glucose 20.2 mmol/l, HbA1c 7.9% consistent with type 2 diabetes mellitus. She started taking metformin. However she was keen to pursue lifestyle driven reversal of type 2 diabetes and so a low carbohydrate diet was recommended restri...

23-year-old woman presented with rapid cycling bipolar disorder (RCBPD) with alternating episodes of mixed affective states, hypomania & severe depression. Quetiapine was initiated & discontinued due to side effects. Levothyroxine was started & gradually increased to 500mcg daily. This was coupled with 6 weeks of low frequency (LF) rTMS. She was clinically euthyroid. TSH <0.01 miu/l (0.27–4.2), fT4 37.1 pmol/l (12–22), fT3 8.4 pmol/l (3.1–6.8), r...

Postural orthostatic tachycardia syndrome (PoTS) occurs as a consequence of the abnormal functioning of the autonomic nervous system (dysautonomia). Despite the many associated conditions, the assessment and relationship to reactive hypoglycaemia has not been explored in the clinical literature.The purpose of this retrospective observational-cohort study was to identify relationships between the physical and biochemical characteristics in potential carbo...

A 50-year-old woman was referred with a history of chronic, symptomatic hypokalaemia. She also had hypertension. There was no history of diarrhoea, increased bowel motions, vomiting, or laxatives/diuretic use. She was not diabetic and she did not have menopausal symptoms. Her mother had seven strokes and myocardial infarction. On examination weight is 69.9 kg, height 1.65 m, BP 163/99, pulse 70, heart sounds normal, and examination of the abdomen was unremarkable. ECG was norm...

There is limited data on vitamin D status in patients with learning disabilities. As a group they possess multiple risk factors for vitamin D deficiency including limited access to sunlight, problems with mobility and anticonvulsant use. We reviewed the data for 105 patients with learning disabilities grouped according to the severity of learning disability (profound, severe, moderate, and mild). Data was available on vitamin D and calcium levels, dose of vitamin D3 needed to ...

A 40-year-old gentleman was referred with sudden onset discomfort in the neck associated with the development of a lump. Earlier that morning he had carried out breathing exercise known as surya krishna at 0600 h and noticed the lump 3 h later whilst shaving. Thyroid USS showed a right-sided thyroid cyst, aspiration of which yielded haemorrhagic contents. FNA of the solid component of the wall did not reveal any malignant cells. The fluid re-accumulated with pressure symptoms ...

A 20-year-old female patient with Graves’ disease was commenced on PTU 50 mg OD in June 2009 because of intolerance to carbimazole. She presented with jaundice within 5 months and was subsequently admitted when she started vomiting 2 months later.She had tenderness in the right upper quadrant. LFT on admission are alkaline phosphatase 268 μ/l (35–104), gamma glutamyl transferase 148 μ/l (5–36), aspartame transferase 194 μ/l ...

While phaeochromocytomas are rare tumours, their identification is essential to avoid morbidity and mortality; their biochemical identification is crucial. Plasma and 24 urinary metanephrines are used as first line investigations, with plasma metanephrines increasingly used first due to its simplicity and high sensitivity/specificity. False positive results, however, can be as high as 20%, particularly secondary to medications; their exclusion is essential to avoid unnecessary...