Endocrine Abstracts

A 34-year old pregnant lady had induction of labour with prostaglandins and oxytocin infusion after her due date. She failed to progress in labour and became slightly disoriented. Urgent biochemistry revealed serum sodium of 124 mmol/l. She delivered a healthy baby by forceps but had post-partum haemorrhage of 1.5 l. Oxytocin infusion was continued along with Hartmann’s solution. She became drowsy and biochemistry revealed serum sodium of 118 mmol/l, low serum osmolality,...

61-year-old-male with a background of treated hypertension and dyslipidaemia presented to accident and emergency with progressive shortness of breath. His most recent bloods were within normal limits. He has a positive family history of cardiac disease, and underwent investigation by CT scanning. This revealed a 10.2 mm anterior mediastinal nodule, which was not avid on PET CT scan. His case was reviewed by the respiratory team and he underwent a left VATs thymectomy. Thymic t...

59-year-old male, with a background of treated acromegaly, presented to endocrine clinic with new onset fatigue. He was diagnosed with acromegally 18 years prior to his presentation, and had a transphenoidal hypophysectomy followed by gamma-knife radiation. Post-surgery he developed partial anterior hypopituatrism (LH and FSH). He currently takes testosterone replacement. He is still receiving medical management with Somatuline. He developed hypothyroidism 16 years following h...

Thyroiditis can often lead to initial thyrotoxicosis and it is important to differentiate among the causes as many cases do not require antithyroid drugs. We present a case report of a 48 year old lady who presented with 10 days history of fever, fatigue, myalgia and a painful goitre after returning from a cruise at Caribbean. Examinations showed pyrexia of 38 C but no localising signs of infection. She had a smooth tender goitre and no signs of thyrotoxicosis. Investigations ...

A 37-year-old woman presented to ED with abdominal bloating and pain. Ultrasound abdomen showed a viable single intrauterine pregnancy at 24 weeks of gestation. Patient was surprised of the diagnosis as she had longstanding premature ovarian insufficiency (POI). She had stage 3B Hodgkin’s disease (HD) diagnosed at 14 years of age when she had BEAM chemotherapy (Carmustine, Etoposide, Cytarabine and Melphalan) followed by autograft bone marrow transplant for recurrent dise...

A 65-year-old lady who was known to hypothyroidism and was treated with Levothyroxine 100microgram once daily for more than 20 years presented to the endocrine clinic with symptoms and signs of thyrotoxicosis. Apart from Levothyroxine, she was taking over-the-counter multivitamins and Vitamin D. Visual fields were full to confrontation and there was no goitre. Thyrotoxicosis was confirmed biochemically and levothyroxine was stopped. Despite being off Levothyroxine for more tha...

A 68-year-old lady was admitted with constipation, epigastric pain, vomiting, occasional coffee ground emesis and melena. She had no chest pain, osmotic symptoms or weight changes. Past medical history was significant for peptic ulcer disease and she was not taking any medications apart from over the counter cod liver oil. She did not have diabetes or cardiovascular risk factors. Her sister had type 1 diabetes. Examination was remarkable for dehydration, mild tachycardia and m...

We present a 60-year-old man who was referred to endocrine clinic with fatigue and a random cortisol of 136nmol/l . He had clear renal cell carcinoma and had right radical nephrectomy 7 years ago. Surveillance scans revealed involvement of mediastinal lymph nodes, pancreas and small bowel and he has pancreatic and small bowel resection in four years ago. He had recurrence a year ago and received Ipilimumab and Nivolumab. Biochemistry revealed low fT4 and inappropriately normal...

A 54 year old Caucasian male presented with progressive muscle weakness leading to complete paralysis in upper and lower limbs evident on examination. Initial venous gas analysis showed potassium of 2.1 mmol/l, and ECG showed U waves with prolonged QTc. A diagnosis of hypokalaemic periodic paralysis was made, and intravenous potassium administered. The paralysis gradually resolved over the next 3–4 h, as repeat serum potassium level rose to 4.0 mmol/l. He described 6 mont...

Dopamine agonists can falsely elevate plasma and urinary metanephrines, thus making the diagnosis of pheochromocytomas in patients taking these medications challenging. We present the case of an 80-year-old female care home resident with a background of hypertension, Parkinson’s disease (PD), dementia and pernicious anaemia. She presented with weight loss, unilateral leg swelling and abdominal distension. A computed tomography (CT) showed a 5.6 cm heterogeneously enhancin...