Endocrine Abstracts

Case history: A 39 year old lady was referred to endocrinology with hirsutism. In the clinic, the pattern of hair growth was confirmed as androgenic, she had cliteromegaly and family members had commented on her voice deepening. She underwent menarche at 13 years old, has menorrhagia and has had hirsutism her entire adult life that had recently worsened. Her biochemistry confirmed hyperandrogenism with non-suppressed LH/FSH. At her second appointment after serious pathology ha...

Introduction: A 77-year-old man with glipizide treated type 2 diabetes presented acutely unwell, with weakness, intermittent breathlessness, and poor glycaemic control (previously well control with HBA1c of 42 mmol/mol). Initial assessment showed body weight of 74.5 kg, mild leg oedema, blood pressure of 190/100 mmHg, expiratory wheeze, oxygen saturation 91% and PO2 7.8 mmHg on air. Chest XR showed chronic right lower lobe shadowing and a bulky hilum. His plasma glu...

Introduction: Within our single centre, the referral rate from the endocrine hypertension clinic to the sleep clinic is high. We have also observed a particular metabolic profile of those patients including raised normetanephrines which subsequently improve after treatment for sleep apnoea.Illustrative cases: 56 year old man with a BMI of 33 kg/m2 and multiple complications of obesity including NAFLD, gallstones and loss of libido. He was rare...

Background: Neuroendocrine tumours (NET) are heterogenous group of tumours commonly arising from Gastro-pancreatic (GI) and pulmonary origins. Combination of bowel resection, disease related diarrhoea and somatostatin analogue therapy (SSA) can contribute to vitamin B12 deficiency (B12D). International guidelines do not suggest routine screening. Total serum cobalamin (B12) level can be falsely normal in patients with B12D. Cells take up B12 in the form of Holotranscobalamin (...

Introduction: 90-95% of patients with primary hypothyroidism respond well to levothyroxine (L-T4) therapy. A minority remain symptomatic despite optimised L-T4 therapy. There is limited evidence supporting the role of liothyronine (L-T3) in this subgroup of patients. By looking at 3- and 6-month trials, we aim to review our practice of L-T4/l-T3 therapy.Method: We reviewed medical and pharmacy records of all patients receiving L-T4/l-T3 therapy from Janu...

Background: Evidence suggested a hypercoagulable state in the context of hyperthyroidism. We presented a case of cerebral venous thrombosis (CVT), a rare but potentially fatal complication of the already high mortality thyroid storm.Case History: A 16year old boy with Asperger’s syndrome was admitted with one-month history of non-specific illness and weight loss followed by 2 weeks of progressive frontal headaches and vomiting, weakness in left arm ...

Background: Fluticasone is an inhaled steroid commonly used for asthma with low systemic bioavailability (~9%). We present a case of significant Iatrogenic Cushing’s syndrome when fluticasone was used simultaneously with antiretroviral therapy.Case: 27-year-old man was diagnosed with HIV in 2021. His antiretroviral therapy was simplified to GENVOYA (elvitegravir/cobicistat/tenofovir/alafenamide/emtricitabine) at the...

Background: Adrenal incidentalomas (AIs) detected on pre surgical scans often present a logistical challenge due to the pressing need for preoperative exclusion of a phaeochromocytoma. Our local guideline recommends endocrinology referral for all AIs for further investigations, including pre clinic 24-hr urine metadrenalines. This approach can be time-consuming, particularly for patients awaiting unrelated surgery.Methods:</stron...

Background: Phaeochromocytomas & paragangliomas (PPGL) are rare neuroendocrine tumours presenting with symptoms of sympathetic overactivity, hypertension, or as adrenal incidentalomas.Study and results: A 24-year retrospective review of a U.K. single-centre PPGL service (2009 -2023) identified 61 cases (53 phaeochromocytomas/8 paragangliomas). Among these, 35 (57%) were females. Mean age of diagnosis was 56.35&pm;16....