Endocrine Abstracts

Anaplastic carcinoma accounts for <5% of thyroid cancer. The simultaneous occurrence of anaplastic carcinoma (ATC) and Graves’s thyrotoxicosis is extremely uncommon with only six cases described in the literature.A 73-year-old female presented with weight loss and atrial fibrillation. Investigations showed TSH-0.02 mU with T4-40 pmol/l and T3-16 pmol/l suggesting thyrotoxicosis.There was no thyromegaly or orbitopathy. TBII was elevated at 10.3 U...

Introduction: Hypothalamic–pituitary adrenal axis dysfunction is common in severely ill patients. Even slight impairment of adrenal response to severe illness can increase morbidity and mortality. Relative adrenal insufficiency has been associated with severe sepsis.Case report: We report a case of 48-year-old lady who was admitted with septic shock secondary to epiglottitis requiring intubation and intensive care. Short synacthen test performed in ...

Introduction: Diabetes insipidus can complicate up to 1 in 30 000 pregnancies and has a variety of causes, some that predate the pregnancy and others that begin during gestation. In addition, women can experience diabetes insipidus de novo in pregnancy through the actions of placental vasopressinase, which causes accelerated degradation of vasopressin. This form of diabetes insipidus may be associated with increased complications of pregnancy, including pre-eclampsia. M...

Background: Resistance to thyroid hormone (RTH) is a rare autosomal dominant condition of altered tissue responsiveness to thyroid hormone (TH) characterised by elevated serum FT4 and FT3 and non-suppressed TSH levels caused by mutation in the thyroid receptor (TR) β gene. Different isoforms of TR are expressed in the heart and regulate genes that encode structural and regulatory proteins. The syndrome is characterised by a variable clinical phenotyp...

Myxedema coma has very high mortality and should be suspected in an acutely unwell patient presenting with depressed mental status who is hypothermic, bradycardic and or hypotensive. Myxedema coma may be the first presentation of people with undiagnosed hypothyroidism. Definitive management is with thyroid hormone but supportive measures, identification and treatment of precipitating factors in an appropriately safe environment are vital. There is no consensus about preferred ...

A 33-year-old lady presented to the surgeons with history of abdominal pain. CT scan abdomen done revealed massive adrenal enlargements reported as adrenal myelolipomas (left gland measuring 8.0×10.9×11.8 cm and multifocal lesions on the right with the larger one measuring 5.2×4.3×3.6 cm). She was referred to the endocrinology team where further history was elicited. She had been diagnosed as a child to have congenital adrenal hyperplasia (CAH) but was lost...

Background: Although hypocalcemia is common post thyroidectomy, no national guidelines pertain to its management.Long-term treatment with calcium and vitamin D replacement predispose patients to nephrocalcinosis and should be avoided in the absence of a clear indication.Aim: To identify the incidence and management of post-operative hypocalcemia following thyroidectomy in a UK teaching hospital with view to formulating management g...

Background: Metyrapone is widely used in the UK for the control of cortisol excess in Cushing’s syndrome, but its use is not standardised. There are a few reports published on metyrapone use, mostly containing small patient numbers.Method: A retrospective survey was conducted across 13 tertiary centres. Using a standardised proforma, extensive data including monitoring and safety information were collected for patients with Cushing’s syndrome o...