Endocrine Abstracts

Case history: A 35-year-old woman with known hypertriglyceridaemia presented with a one day history of abdominal pain, vomiting and fever. She was 14 weeks pregnant having conceived spontaneously following a period of infertility. She had discontinued her lipid-lowering medication and was managed with diet alone. On examination, she was pyrexial, tachycardic (HR=100 bpm), normotensive (BP=111/71 mmHg), oxygen saturation was 96% on air and she had a tender distended abdomen. A ...

Introduction: Endocrine society guidelines advocate early colonoscopy and monitoring for acromegaly-associated complications and recurrence. We aimed to establish whether people with acromegaly under our care received appropriate monitoring.Methods: Patients under follow-up with acromegaly diagnosed 1989-2021 were included. Electronic health records were accessed for clinic letters, colonoscopy reports, blood and imaging results from the diagnosis to rec...

Introduction: Levothyroxine, the standard therapy for hypothyroidism, is usually well tolerated and very few cases of true allergy to levothyroxine have been reported to date. Here we report two cases of rare occurrence of levothyroxine allergy.Case 1: A 56-year-old woman with no previous history of allergies started levothyroxine post-thyroidectomy for Graves’ disease. She developed facial flushing and urticarial rash within 15 minutes of the first...

Introduction: Clinical practice guidelines advocate testing the aldosterone-renin ratio (ARR) in specific circumstances only. Tests should be taken following abstinence from drugs associated with false results. We aimed to determine the appropriateness of testing locally and any associated wasted healthcare costs.Methods: We retrospectively evaluated ARR requests taken July-October 2019 and July-October 2021 in Swansea Bay University Health Board to dete...

Introduction: Profound thyrotoxicosis commonly presents with heat intolerance, sweating, weight loss, palpitations, tremor, goitre and eye signs in the case of Grave’s disease. Typically, thyroid storm is differentiated by marked volume depletion, congestive cardiac failure, cardiac arrhythmias, confusion, nausea and vomiting, often with extreme agitation. The wide-ranging and systemic manifestations associated with profound hyperthyroidism are mediated through the thyroi...

Fluid restriction (FR) is the recommended first-line treatment for chronic hyponatraemia due to syndrome of inappropriate antidiuresis (SIAD) in expert guidelines, despite the lack of prospective data to support its efficacy. We aimed to test the hypothesis that FR was more effective than no treatment. 46 patients with chronic SIAD were randomised to either fluid restriction (1 litre/day, FR) or no specific hyponatraemia treatment (NoTx) for one month. Inclusion criteria were ...