Endocrine Abstracts

In higher education, endocrinology teaching is often delivered by academic researchers and endocrine physicians, however their involvement in teaching is rarely the primary focus of their job plan. As such, opportunities to develop as an educator are often triaged behind primary responsibilities such as research, funding applications, publications and patient care. Undergraduate and postgraduate medical education is delivered across a range of settings (classroom, lab, bedside...

We present a rare case of Non- Hodgkins large B Cell lymphoma presenting as circulatory collapse and acute adrenal insufficiency. A 47 year old woman was referred with a 1 month history of weight loss of 7 kg and vomiting. Shortly after admission her condition deteriorated and she developed acute hypotension, BP was 92/58 mmHg, heart rate 100/mn and required volume resuscitation. Examination revealed a thin woman with generalised hyperpigmentation. Serum sodium was 130 mmol/l,...

Swyer syndrome (pure gonadal dysgenesis) is characterised by female phenotype with a 46 XY genotype due to a mutation of the sex determining region (SRY) gene on the y chromosome. A 28 year old presented with back pain after an accident and had a 2nd lumbar vertebral fracture and severe osteoporosis. The DEXA scan T score was −4.2. Procollagen Type 1 pro peptide and Osteocalcin levels were high. She had been in good health and denied any family illness. She was 180 cm ta...

Radiation to the neck is known to be associated with the later development of hypothyroidism. The possibility of acute radiation-induced thyrotoxicosis is not generally recognised. We report here a case of acute hyperthyroidism shortly after radiotherapy.A 57-year-old man with poorly differentiated adenocarcinoma of the left parotid underwent parotidectomy with radical neck dissection followed by radiotherapy. He received 65 Gy by intensity modulated rad...

Hypothyroidism is common condition with a strong female preponderance and a UK prevalence of ~2%. It is normally treated with replacement oral levothyroxine.Morbid obesity is a costly public health issue with a prevalence in England of ~3% with two-thirds of sufferers being female. Weight loss surgery is increasingly employed as a successful and cost effective intervention for super-morbidly obese patients (BMI >40 kg/m2) in accordance wit...

NICE guidelines (2008) recommend that patients with gestational diabetes (GDM) should no longer have post-partum review with glucose tolerance test (GTT), but that fasting blood glucose is sufficient. We have undertaken a retrospective study of post-partum GTT in patients with GDM, to examine whether the 2 hour glucose value adds useful additional information. Notes of 208 patients with GDM in 2003–2008 were reviewed, and the results of post-partum GTT were collected. 175...

Discordant thyroid function is common; differential diagnosis includes assay interference, familial dysalbuminaemic hyperthyroxinaemia, thyroid hormone resistance (RTH) and TSHoma. We present four TSHomas, demonstrating the diversity of clinical course. All had assay interference and RTH excluded. Case 1: A 64-year-old lady with thyrotoxic symptoms and no family history. TSH 6.36 mU/l, with fT4 32.6 pmol/l and raised SHBG. Pituitary MRI showed a 7 mM lesion. She was unresponsi...

A 50-year-old woman with learning difficulties and schizophrenia presented to accident and emergency with 5 days of epigastic pain and vomiting.Initially, she was peripherally shut down, with a pulse of 120 and blood pressure of 115/80. Chest examination was normal. Abdominal examination showed epigastric tenderness with guarding.Blood tests confirmed a diagnosis of acute pancreatitis (Amylase 1972 IU/l), with hypercalcaemia (corre...

Acute and long-term complications attributable to diabetes are regrettably still common. To monitor for the development of such complications NICE recommend regular measurement of certain criteria to enable early intervention. A previous audit performed in our hospital looked at the adherence of paediatric diabetic reviews to NICE guidelines. As a consequence of this audit a detailed pro-forma to be used at all paediatric diabetic reviews was introduced....

Graves’ disease is the most common cause of hyperthyroidism in children. The incidence in the UK and Ireland is unknown but estimated to be 0.84 per 100 000 people (0–15 yr olds). Due to an apparent high local incidence, a retrospective study was conducted on patients diagnosed with Graves’ disease in a district general hospital in the locality.Aim: To evaluate the clinical features, investigations and treatment of patients diagnosed from ...