Endocrine Abstracts

A 73-year-old lady presented to our department with a 6-month history of facial hirsutism and frontal hair loss. Her past medical history comprised of type 2 diabetes and hypertension. Initial blood tests showed testosterone 15.9 nmol/l (normal range 0–1.7), SHBG 123.6 nmol/l, LH 23.1 iu/l (normal range 16–64), FSH 33.5 iu/l (normal range 16–64), oestradiol 281 pmol/l (normal <43), mild erythrocytosis, mild hyperbilirubinaemia and HbA1c 56 mmol/mol (normal &...

Introduction: Hypothyroidism including its subclinical form affects about 3% of pregnant women. It has adverse effects on pregnancy and the fetus with evidence of impaired intellectual development. The fetal thyroid gland reaches maturity by 12 weeks of gestation. Hence in the first trimester of pregnancy the fetus is dependant on the mother and optimising serum levels of thyroxine is important.Methods: we conducted a retrospective audit of the managemen...

A 61-year-old man was referred to the Endocrinology clinic with a 5-month history of hyponatraemia. It was first detected as part of a routine test, which revealed a serum sodium of 124 mmol/l. His serum osmolality was 253 mOsmol/kg, urine sodium was 32 mmol/l and urine osmolality 317 mOsmol/kg. His results suggested SIADH. He already had a chest X-ray and brain MRI scan done which were reported as normal. His thyroid function test and short synacthen test were normal. He had ...

Introduction: Amiodarone is a commonly prescribed antiarrythmic drug. It can cause potentially serious adverse effects involving the thyroid gland, lungs, liver and eyes. It is recommended that patients on amiodarone have regular monitoring tests.Methods: We conducted an audit of patients who were prescribed amiodarone by various physicians in our hospital between January 2007 and March 2008. The data was obtained from the patients case notes. We looked ...

Increasing use of abdominal imaging has led to an increased detection of incidental adrenal masses. These cases are usually referred to the endocrinologist for further investigations. We present two cases with unusual incidentalomas. Case 1: a 63-year old man presented with acute abdominal pain. He was haemodynamically stable and afebrile. Investigations revealed normal biochemistry, amylase and clotting. White cell count raised, haemoglobin and platelets normal. Chest ...

A 61-year-old female, with a previous history of left nephrectomy for papillary renal cell carcinoma, presented with lethargy. Her initial blood tests revealed an adjusted calcium of 4.26 mmol/l (normal range 2.2–2.6) associated with acute renal impairment (creatinine 432 μmol/l, urea 25 mmol/l) and low PTH of 9 ng/l (normal range 20–75). Following rehydration with IV fluids and IV pamidronate administration, her adjusted calcium normalised to 2.37 mmol/l. The i...

A 26-year-old man presented with a 3-month history of polydipsia, polyuria and nocturia. Physical examination was unremarkable. Random blood glucose was 5.1 mmol/l, sodium 147 mmol/l, serum osmolality 297 mOsm/kg, urine osmolality 81 mOsm/kg. A water deprivation test confirmed cranial diabetes insipidus. Magnetic resonance imaging (MRI) of his pituitary gland revealed nodular thickening of the pituitary stalk suggestive of inflammatory or neoplastic aetiology. He also complain...

A 69 year old lady with a known history of bipolar disorder presented with confusion, falls, cough and pyrexia. Initial blood test revealed a sodium of 153 mmol/l, potassium 4.7 mmol/l, urea 13.1 mmol/l and creatinine 230 μmol/litre, PH 7.35 and bicarbonate 23. A repeat test few hours later revealed a sodium of 164 mmol/l, serum osmolality 349 mosm/kg and blood glucose 30.3 mmol/l. Urine ketones negative. Her 24 hours urine output went up to 9000 ml and her sodium to 175 ...

52 year old lady was referred to the endocrine clinic with h/o lethargy and tiredness. She also had mild tremors. She denied weight loss, palpitations or diarrhoea. Past medical history includes bipolar disorder. She was on Venlafaxine, Carbamazepine, Pregabalin and HRT. GP has done thyroid functions because of the symptoms and results are as below. TSH: 7.15 mIU/l(0.38–5.50), FT4:24.3pmol/l (10.0–18.7) on 05.02.2020 TPO:<10 IU/Ml This was rechecked in a different laborator...