Endocrine Abstracts

Although amyloid deposition can cause a goitre thyrotoxicosis secondary to amyloidosis is rare. We report a case of fatal systemic amyloidosis presenting as thyrotoxicosis.A 62-year-old previously healthy male presented with heat intolerance, weight loss and tremor. On examination he had moderate sized firm goitre and mild dysthyroid eye disease. Biochemistry confirmed thyrotoxicosis; serum free T4 47 pmol/l (normal 10–25) freeT3 14.4 pmol/l (normal...

We present a case of 55 years old obese man with type 2 diabetes of 13 years duration, seen in diabetes clinic. His HbA1c had been 8–10% for about 7 years despite being on maximum doses of sulphonylurea and metformin.It was decided to start him on 30/70 mixed insulin and Metformin was continued. His HbA1c did not improve despite aggressive insulin titration. His injections became painful as insulin doses increased and resistance was noted on injecti...

In 1981 a 33yr old woman was diagnosed with Graves thyrotoxicosis and type 2 diabetes mellitus. At diagnosis her BMI was 19 kg/m2 and she was initially treated with carbimazole and glibenclamide. She had a past medical history of idiopathic lymphoedema, asthma and bronchopulmonary aspergillosis and was regularly reviewed by an ophthalmologist for hyperpigmented maculae.In 1991 she required insulin to control her diabetes and developed progress...

In 1981 a 33 yr old woman was diagnosed with Graves thyrotoxicosis and type 2 diabetes mellitus. At diagnosis her BMI was 19 kg/m2 and she was initially treated with carbimazole and glibenclamide. She had a past medical history of idiopathic lymphoedema, asthma and bronchopulmonary aspergillosis and was regularly reviewed by an ophthalmologist for hyperpigmented maculae.In 1991 she required insulin to control her diabetes and developed progres...

UNUSUAL PRESENTATION OF DIABETES FOOT ULCERAM Mousa, G Knight, S Muzulu, J R Rochester. Rotherham General Hospital, Moorgate Road, Rotherham S60 2UD.IntroductionPhalangeal metastases commonly display inflammatory symptoms that mimic an acute infection. We describe a rare case of bronchogenic carcinoma with metastases to the left 3rd and 4th toes, which presented as presumed diabetic foot ulceration.<p cla...

A 27-year-old woman with Carney Complex, with inactivating mutation of the PRKAR1α gene [(a 2-bp deletion of nucleotides T and G at positions 576 and 577 with frame-shift mutation beginning with aminoacid residue threonine 163 (ΔFSterThr163)], bearing a GH secreting microadenoma, Cushing syndrome from PPNAD and with high operatory risk because of the neurological sequelae of cerebral embolism from atrial myxomas, underwent a low-dose mitotane (MT) regimen.<p clas...

Hyponatremia may manifest with nausea, disorientation, seizures, coma, cerebral edema and even death. The etiology of hyponatremia as paraneoplastic syndrome has been attributed most often to high levels of vasopressin. Correction of hyponatremia is usually successful at moderately low sodium levels, although it must be done slowly to prevent osmotic demyelination. Gastrointestinal stromal tumors (GISTs) rarely present paraneoplastic reactions, a few cases have been reported.<...

Background: Dopamine agonists (DA) are used as the first-line trearment in patients with macroprolactinomas. Late resistant to DA(cabergoline) therapy may occur. Patient with resistant macroprolactinoma may end up receiving a relative high dose of DA. These patients should be advised to take up radiotherapy option as earlier as possible to avoid the need of high dose dopamine agonist. We present a 63-year-old man who presented in 1999 with visual loss,due to giant macroprolact...

Background: GH therapy in adolescents with childhood onset GH deficiency (CO-GHD) is often necessary to prevent adult GHD syndrome and requires a re-evaluation of the GH axis on attainment of final height. Not all individuals with CO-GHD remain GH deficient and re-evaluation is required to confirm or refute adult GHD.Aim: Review the care received by young adults diagnosed with CO-GHD.Design: Retrospective review of young adults wit...

Pregnancy is a state of physiological hyperphagia and represents a good model to unravel the mechanisms involved in feeding regulation. The hyperphagia is the main responsible for the positive energy balance in gestation, which is necessary for maintaining maternal energy stores. The presence of high serum leptin levels and hyperphagia during pregnancy is a paradoxical event and reflects a state of leptin resistance. In order to evaluate the mechanisms for hypothalamic leptin ...