Endocrine Abstracts

Case history: A 70 year old man presented with a six month history of sore throat and dysphagia. His past medical history included Type 2 diabetes and dysarthria due to tracheomalacia following tracheostomy at the age of 40 when he was involved in a road traffic collision. Initially he was diagnosed with gastroesophageal reflux, but symptoms did not settle with proton pump inhibitor medication. He as therefore referred to the ENT team for further evaluation.<p class="abste...

30 years old female with history of sinusitis, anxiety states, diagnosed with relapsing multiple sclerosis from May 2005, initially had abnormal sensation and weakness of left side of body with MRI finding of demyelinating lesion in the cervical cord, treated with i/v methyl prednisolone with good recovery. Unfortunately had multiple relapses, therefore treated with two doses of Alemtuzumab since June 2012, presented with shakiness and a rash in her neck in July 2012. Clinical...

A 73-year-old female, fit and well otherwise, was not any regular medications, was diagnosed with choroidal melanoma in 2010, and enucleated, subsequently had DTIC for multiple metastasis in 2014. She also received ipilimumab for 3 months as second line treatment for metastases. Presented to neurosurgeons with cold intolerance and dizzy spells, random cortisol was <30, started on dexamethasone 1 mg twice daily. Also had a low TSH of 0.71 with low free T4. Short ...

Introduction: Pituitary dysfunction is a recognised complication of traumatic brain injury; it usually involves multiple hormones and can be transient. We present a case of traumatic pituitary haemorrhage resulting in late onset persistent isolated cortisol insufficiency. Case report: A 40 year old man sustained head injury following a road traffic collision. CT brain scan soon after the event was unremarkable. He then developed drowsiness and confusion. MRI scan of the brain ...

Introduction: Hypothyroidism is usually easily treated with levothyroxine tablets. Patients who show poor response to oral therapy are usually found to have inadequate absorption of levothyroxine, or non-compliance. We report a case where intramuscular thyroxine was used successfully in treating a case of resistant hypothyroidism due to possible malabsorption. Case report: A 47 year old lady with primary hypothyroidism, diagnosed aged 34 years, was referred to the endocrine cl...

We present the case of a 73-year-old woman, who presented with ascites and a history of left radical hemithyroidectomy for localized follicular thyroid carcinoma (FTC) 28 years ago. Computed tomography (CT) scanning of her body revealed extensive metastatic lesions. An omental biopsy showed features suggestive of thyroid follicular epithelial cancer. Serum thyroglobulin was raised at 127 μg/l. She died before the biopsy result was received. Two years before presentation, ...

Congenital adrenal hyperplasia (CAH) is a group a rare autosomal recessive disorders characterised by a deficiency on one of the enzymes necessary for cortisol biosynthesis. More than 90% of CAH is caused by mutations or deletions in cytochrome P450 21-hydroxylase gene. Impaired glucocorticoid synthesis results in chronic elevation of ACTH causing adrenal hyperplasia and accumulation of steroid precursors such as 17-hydroxyprogesterone (17-HOP). The main goal in CAH managemeng...

Background: Raised prolactin is a frequent reason for referral to endocrine clinics. Prolactinomas are the most common functioning pituitary tumours. Medical management with dopamine agonists remains the treatment of choice. MHRA advises baseline echocardiograms within 3–6 months and then 6–12 monthly in patients taking dopamine agonists due to a potential risk of cardiac valvular fibrosis though the evidence for fibrosis at endocrine doses remains limited. Aim: The ...

Background: Severe maternal hypothyroidism during pregnancy may be associated with delayed development and lower IQ in the foetus. BES (2007) and NICE (2011) guidelines recommend maintaining TSH<2.5 mU/l with monitoring of maternal thyroid function test (TFT) 4 weekly, especially in the first trimester.Aim and methods: A retrospective study on all pregnant women with established hypothyroidism attending the Joint Antenatal Clinic (JANC) at Liverpool ...

We previously reported a case of non islet cell tumour hypoglycaemia (NICTH) due to increased ‘big’-IGF2 production in a lady with haemangiopericytoma (HAP). We now describe the challenges in managing this lady who had recurrent, disabling hypoglycaemia requiring frequent hospitalisation.This patient presented with symptomatic hypoglycaemia 15 years after the diagnosis of parasaggital HAP. At presentation she had tumour recurrence with liver an...