Endocrine Abstracts

Case History: A 69-year-old lady was admitted to her local district general hospital with a history of confusion, memory disturbance and focal twitching affecting her upper limbs and face. She had a past medical history of type 2 diabetes mellitus, hypertension, hypercholesterolaemia and ischaemic heart disease. Her medications included gliclazide, pioglitazone, atorvastatin, bisoprolol, aspirin and omeprazole. She had never smoked and was teetotal. Neurological examination on...

A 58 year-old Polish lady was admitted to hospital after having had two tonic-clonic seizures. She reported a previous history of seizures but had been seizure-free for 10 years. In addition, she reported a 20 year history of hand spasms and perioral paraesthesia. As part of the investigation for seizures while she was living in Poland 10 years ago, CT head had shown bilateral basal ganglia calcification and on this basis she had been diagnosed with Fahr...

A 58 year-old Polish lady was admitted to hospital after having had two tonic-clonic seizures. She reported a previous history of seizures but had been seizure-free for 10 years. In addition, she reported a 20 year history of hand spasms and perioral paraesthesia. As part of the investigation for seizures while she was living in Poland 10 years ago, CT head had shown bilateral basal ganglia calcification and on this basis she had been diagnosed with Fahr...

A 85-year-old man presented with a 2-week history of malaise, confusion and agitation and 4 weeks of polydipsia and polyuria, with water intake of 6 l/day. His past medical history included hypertension, congestive cardiac failure, and chronic kidney disease. On examination he was hypervolaemic. Initial investigations were as follows: serum sodium 115 mmol/l, potassium 4.6 mmol/l, urea 8.1 mmol/l (2.5–7.8), creatinine 138 μmol/l (66–112), serum osmolality 245 mO...

A 53-year-old Asian supermarket produce supervisor was noted at work to have slurred speech, sweating, and to feel lightheaded. Paramedics were called and on arrival his capillary blood glucose (CBG) was 1.7 mmol/l. This rose to 2.7 mmol/l after he was given glucose gel followed by complex carbohydrate. He remained lightheaded so was taken to hospital. CBG on admission was 2.0 mmol/l, so samples were taken for plasma glucose, insulin, C-peptide and sulphonylurea screen. Plasma...

Radioactive iodine (RAI) therapy is the usual treatment of choice for hyperthyroidism. We have demonstrated a success rate of 88% (euthyroidism or hypothyroidism) over a 5-year period. We are very happy to recommend RAI, however patients still express concerns.There is little literature available about patients’ reactions to RAI: to our knowledge, only two studies. We performed a survey of our RAI treated patients. Of 143 patients contacted, 87 repl...

Case history : A 44-year-old female presented with 6-week history of gradual deterioration in her left vision associated with eye pain. She saw an ophthalmologist who noted that she had reduced visual acuity (6/24) and colour vision (Ishihara colour vision score 3/15) in her left eye with left relative afferent pupillary defect (RAPD). It was thought that she may have a left retrobulbar neuritis so she was advised to attend A&E for an urgent neurology assessment. On examin...

We present the case of a 33-year-old woman diagnosed with congenital adrenal hyperplasia (CAH) due to classical 21-hydroxylase deficiency following a salt-losing crisis as a newborn. She had previously been controlled on dexamethasone 0.25 mg bd and fludrocortisone 100 mcg od, as evidenced by high-normal 17-hydroxyprogesterone (17-OHP) and low-normal testosterone levels (8.5 and 0.4 nmol/l respectively).However, she had experienced significant symptoms o...

Our 42-year-old patient presented with breathlessness and signs of congestive cardiac failure. Her ‘spade-like hands and acromegalic appearance’ were noted on the post-take round. She had headaches, orthopnoea and secondary amenorrhoea. She was a poorly controlled diabetic (so OGTT was not performed), anaemic, and previously had a thyroidectomy.Pituitary profile showed secondary hypogonadism, normoprolactinaemia and normal free T4 indicating ad...