Endocrine Abstracts

Introduction: Familial Hypercholesterolaemia (FH) is an autosomal dominant inherited disorder of lipid metabolism. Affected children have elevated cholesterol from birth with accelerated atherosclerosis and significant cardiovascular disease (CVD) from the third decade. 1 in 250 people are affected and early treatment can eliminate the risk of premature CVD. Genetic testing guidance was published in August 2008 and a CVD outcomes strategy was produced in 2013. From 2014 the Br...

Background: Incidence of type 2 diabetes (T2DM) is increasing in children and young people under the age of 18 years. This group has a higher risk of microvascular complications and a more adverse cardiovascular risk profile than those diagnosed later. Weight loss is essential for remission, but intensive input is often required to achieve this.Aims: 1. Describe the demographics of our T2DM population2. Look at our remission rates<...

The main-stay management of Beta thalassaemia major is blood transfusion but this carries a risk of endocrinopathy from hemosiderosis in endocrine organs. Iron chelation therapy aims to mitigate this risk. Access to this therapy isn’t available in some healthcare systems. Known Syrian refugee diagnosed with Beta thalassaemia major in infancy referred via the refugee medical services for thalassaemia management. There was previous history of intermittent transfusion suppor...

Case history: We describe a case of 35 year old female who presented with abdominal pain, nausea and lower backache. She was initially treated with Trimethoprim for a urinary tract infection. 5 days later, she re-attended hospital with feeling more unwell, ongoing lower abdominal pain and vomiting. On examination, she was haemodynamically stable. She had suprapubic tenderness on abdominal palpation, and the rest of her systemic examination was normal.Inv...

Thyrotoxicosis is one of the most common clinical problems in patients referred to endocrine clinic. TRAb is specific for graves disease (GD) and radioisotope scan (RIS) is useful diagnostic test in the investigation of thyrotoxicosis. RIS is commonly used when TRAb is borderline or negative to exclude thyroiditis.Aims and methods: To look at the use of RIS in the investigation of thyrotoxicosis and sub-clinical hyperthyroidism (SCH), and use of anti-thy...

Introduction: Heart failure is a complication of thyrotoxicosis. We present 2 unusual cases presenting with pulmonary hypertension with isolated right heart failure that reversed after treatment.Case description: Case 1: A 55-year-old man presented with weight loss, dyspnoea and leg swelling. HR: atrial fibrillation 51/min. He had a raised JVP, tricuspid regurgitation and severe pitting oedema. Pro-BNP: 4995 pg/...

Case history: A 26 year old female with severe gastro-oesophageal reflux disease was seen in our service for assessment prior to roux-en-Y gastric bypass (RYGB) surgery for this condition. She had additional history of obesity, hypertension, insomnia, cholecystectomy for gallstones and anxiety-depression. At age 18 her weight was 85 kg, BMI 28 kg/m2. She gained 40 kg over the subsequent 8 years and in clinic was 123 kg, BMI 41.1 kg/m2 with a gynaecoid pat...

Background: Bariatric surgery is considered the most effective tool to manage the growing pandemic of obesity related health disorders. Lack of regular surveillance following bariatric procedures can put patients at risk of developing serious micro-nutritional deficiencies and related complications.Case report: A 51-year-old lady presented to the bariatric services in 2015 with long standing neurological symptoms including memory and cognitive impairment...

A 34-year old lady presented in the postpartum period following her 3rd pregnancy with severe hypertension. Her first two pregnancies were 3 and 5 years previously where she delivered via elective Caesarean section without any complications. During this pregnancy which was a twin pregnancy, her antenatal care was mainly unremarkable but on specific questioning, she reported increased sweating for a period of 4 months. Her blood pressure was noted to be normal during her antena...

Case history: An 80-year-old female presented with progressive leg and facial swelling, postural dizziness, generalised lethargy and reduced mobility. She suffered with chronic kidney disease (stage 3), rheumatoid arthritis and hypertension and had undergone partial thyroidectomy. Examination revealed marked bilateral leg oedema to the sacrum, facial oedema, an ejection systolic murmur, normal JVP and a clear chest.Investigations and results: Investigati...