Endocrine Abstracts

Introduction: Cortisol insufficiency has been reported following cardiac surgery in infants but has not been associated with postoperative complications. In our hospital serum cortisol is measured following cardiac surgery when hypotension is refractory to two inotropes at maximal dose.Methods: Retrospective case note study to describe features of adrenal insufficiency in post-operative cardiac patients with low serum cortisol.Resu...

A 20 year old Asian housewife presented with a history of irregular periods and six months subfertility. On May 1 2002 she had a prolactin of 2,200 mIU/L (normal range 63-211) and subclinical hyperthyroidism : thyroid stimulating hormone (TSH) 0.3mIU/L (normal range 0.4-5.5) and free thyroxine (fT4) 12.6 pmol/L (normal range 10.3-23.2). At her first hospital visit on September 9 2002 she was 9 weeks pregnant. She did not have hyperemesis gravidarum. On examination, she was cli...

Schizophrenia is associated with higher risk of Type 2 diabetes. There are several reports of Type 2 diabetes presenting as diabetic ketoacidosis, particularly in young obese African-Caribbean subjects. We report 3 cases of new onset diabetes presenting with diabetic ketoacidosis (see Table 1) in African-Caribbean males treated with olanzapine for chronic schizophrenia.Table 1 Metabolic parameters on admissionCase</td...

A 35-year-old lady was admitted at 24 weeks gestation with a 3–4 weeks history of persistent severe, left sided headaches associated with vomiting but not with visual disturbance. She had a prior history of migraines. However, her current headaches were very different in character. On examination her Glasgow Coma score was 15. There was no neck stiffness or photophobia. Visual fields and fundoscopy was normal. She was haemodynamically stable. Magnetic resonance imaging (M...

Background: Holoprosencephaly (HPE) is a brain malformation that results from a defect in the patterning of the forebrain. Children with the most severe forms of HPE have endocrine deficits, in addition to neurologic and visual impairment. Forebrain abnormalities and pituitary hormone deficiencies are also part of the clinical spectrum of septo-optic dysplasia (SOD).Aim: Describe the spectrum of endocrinopathies in children with HPE and compare their cha...

The Charcot joint was originally described as tabetic arthopathy and published in 1868. This occurs in approximately 0.2% of people with diabetes and usually involves a prior peripheral neuropathy. Other factors involved in the pathogenesis of this osteoarthropathy are autonomic neuropathy & trauma.A 74-year-old male presented in August 2004 with a subacute history of right foot swelling & discomfort. There was no discreet history of preceding tr...

Non-alcoholic steatohepatitis is part of the spectrum of non-alcoholic fatty liver disease. It is characterised by triglyceride deposition in the liver associated with a lobular hepatitis and elevated circulating aminotransferases. It is associated with insulin resistance and commonly occurs in Type 2 diabetes but is much less widely recognised in patients with Type 1 diabetes.A 29 year old Caucasian male with longstanding Type 1 diabetes presented with ...

The differential diagnosis of post-partum thyrotoxicosis includes Graves' disease and post-partum thyroiditis(PPT). We present two cases which demonstrate the difficulty of interpreting 99mTc-pertechnetate scans in this setting. Case 1 is a 37 year-old lady who presented 5 months post-partum with a month history of palpitations, sweating and heat intolerance. Investigations revealed TSH < 0.01 mU/L, fT3 8.9 pmol/L (NR 10.5-22.7 pmol/L) and fT4 23.4 pmol/L (NR 3.5-6.5 pmol/)...

In August 1999, to reduce pressure on an overcrowded outpatient department and the incidence of undetected early hypothyroidism, we implemented a new protocol for the follow-up of patients undergoing radioiodine treatment for recurrent thyrotoxicosis. Suitable patients are invited to participate in follow-up by telephone. Thyroid function tests are checked at 3, 6, 9 and 12 weeks post-treatment. Patients who become hypothyroid post-treatment (fT4 <14 picomoles per litre) a...

A 60-year-old gentleman who had previously undergone a right nephrectomy for renal cell carcinoma was admitted electively for a left adrenalectomy due to metastatic disease. Prior to this he had been treated with immunotherapy (Sunitinib) and radiotherapy for pulmonary and bony metastases respectively. He was given perioperative cover with hydrocortisone. A short synacthen test (SST) performed the morning after discontinuing hydrocortisone showed a baseline cortisol of 406 nmo...