Endocrine Abstracts

Aim: In the thyrotoxicosis local investigation protocol, Tc99m pertechnetate scintigraphy technetium scan is used to assess the presence of thyroid uptake and both the degree and pattern of uptake. TSH receptor antibodies are used to demonstrate the presence and activity of autoimmune thyroid disease. We audited the utility of these investigations in a series of thyrotoxic patients.Methods: Forty-nine patients (11 men, 38 women, mean age 47.5±38) we...

A 19-year-old, female of West African descent presented with a 5 months history of thyrotoxicosis. The GP had commenced carbimazole. She had continuing clinical and biochemical thyrotoxicosis TSH <0.01 (0.3–5.5 mU/l), FT4 68.0 (9–20 pmol/l) and FT3 18.9 (3.4–5.6 pmol/l). Thyroid antibodies were present at elevated titre and technetium uptake scanning showed toxic diffuse hyperplasia with an uptake function of 37%, confirming Graves&#146...

A 73 years old female presented in 2005 with 8 year history of face and body hirsutism. Examination confirmed hirsutism but there were no other masculinization features. Her initial investigations revealed a high testosterone of 13 nmol/l, normal androstenedione, DHEA-S and 17 hydroxy progesterone. CT and U/S of pelvis and abdomen, showed normal adrenals, ovaries and a large calcified uterine fibroid. Urinary steroid metabolites ruled out adrenal testosterone source and exogen...

We present a 44-year-old female referred to us with a two year history of episodic palpitations, chest tightness, headaches and pallor associated with hypertension. She had previously been extensively investigated by neurologists and cardiologists including MRI of the brain, renal ultrasonography, 24 h tape and echocardiography – all normal. Given the history, a CT of the adrenals was performed in 2007 which revealed a 1.5 cm nodule in the right adrenal with abnormal enha...

Background: Vitamin D deficiency in pregnancy is a growing public concern amongst ethnic minority groups in the UK. This is related to both skin colour and clothing.Aim: To investigate vitamin D status in four ethnic groups in an inner city obstetric practice. This was part of an ongoing study of vitamin D deficiency and supplementation in pregnancy.Subjects: Women from St Mary’s Hospital, London were recruited at 28 weeks ges...

A 23-year-old Rwandan lady was 27 weeks pregnant and reported feeling non-specifically unwell for 3 days followed by 24 h of diarrhoea and vomiting. She denied fever, rash, polyuria, polydipsia, weight loss or foreign travel. She has sickle cell trait with no other past medical history. Laboratory glucose at 16 weeks gestation was 5.1 mmol/l.On admission she looked unwell and was tachycardic and dehydrated. Her capillary blood glucose was 17.9 mmol/l and...

Recently updated international guidelines recommend specialist surveillance of adults with Turner Syndrome (TS). In 2005, we established a dedicated TS clinic, attracting referrals from our general endocrine service and other specialities including primary care.Twenty-three patients currently attend of whom 9 were previously under endocrinology review. Karyotypes include 45XO (8/23), 45XO/46XrX (4/23), and 45XO/46XiXq (3/23). Mean (±S.D.</sma...

Previous published reports from Hong Kong have suggested iron markers may be increased in mothers with gestational diabetes. We examined this in our predominantly Caucasian population. Serum iron, ferritin and total iron saturation index (TSI)) where measured in sixty mothers with gestational diabetes compared to controls matched for age and parity. All participants were Caucasian. The study had LEC approval. Gestational diabetes was defined as glucose of 7.8 mmol/l or more in...

Aggressive angiomyxoma (AA) is a rare mesenchymal tumor which is more common in females, occurring predominantly in the pelvi-perineal region. It tends to be locally aggressive with high recurrence after primary excision. The majority of these tumors are positive for oestrogen and progesterone receptors. Hence hormonal manipulation provides the possibility of effective treatment.Since 2005, we have been treating two female patients with AA medically (see...

A nineteen year old man was admitted by his GP with profound weight loss. He had avoided contact with primary care services as he feared doctors, but had been referred to an eating disorders clinic. He had a diet of exclusively snack food and had been losing weight for two years.On examination he was cachectic and pale with scanty body hair. His body mass index was 13 kg/m2, with a weight of 44 kg. He was clinically thyrotoxic, a small diffuse...