Endocrine Abstracts

Thyroid disorders are common among women of childbearing years. However, the diagnosis of thyroid disorders during pregnancy is confounded by the normal alteration in thyroid physiology. Serum TSH levels decrease at the end of the first trimester, mirroring the increase in serum hCG levels; hCG is thyrotropic and causes a slight increase in serum free T4 concentrations. With the drop in serum hCG as pregnancy progresses, serum free T4 levels decline and may decrease below the ...

Multiple Endocrine Neoplasia Type 1(MEN1) syndrome is commonly associated with the three ’P’s-pituitary, parathyroid and pancreatic lesions. However, increasingly, thoracic neuroendocrine tumours (NETs) are being recognised with the syndrome. We present a case of MEN1 syndrome who primarily presented with a lung carcinoid tumour. A 31-year-old lady with without a significant past medical history presented with 2-month history of a persistent cough. ...

Case history: A 32 year old male diagnosed with McCune-Albright syndrome aged 18, presented with a painful left knee and difficulty in walking, limiting his usual activities. He was diagnosed with Acromegaly (IGF-1 451 ng/ml, mean GH 2.71 ug/L) aged 26 years and had multiple sites of fibrous dysplasia, causing bone pain. On examination he had tall stature and features of acromegaly with normal visual fields and palpable masses behind his left knee and upper thigh.<p class=...

Case History: A 57 year old male, who was known to have primary hyperparathyroidism was admitted to hospital due to hypercalcaemia on routine blood tests (adjusted S. calcium- 3.44 mmol/l.) He had no symptoms due to hypercalcaemia. This was his 5th admission since the diagnosis 18 months ago, each admission requiring treatment with IV fluids and IV bisphosphonates. SESTAMIBI and ultrasound scans of the thyroid and parathyroids had previously localised a likely right inferior p...

Introduction: With increasing prevalence of hypogonadism, testosterone replacement therapy (TRT) remains the mainstay of treatment for male hypogonadism. Polycythaemia, the commonest reported side effect of TRT is often claimed to be less with transdermal preparations than intramuscular.Case history: A 48 years gentleman, initially presented in primary care with reduced libido, erectile dysfunction(ED), low energy levels. Early morning testosterone level...

Introduction: DKA is often seen in people with Diabetes Mellitus I and seldom in Diabetes Mellitus II but rarely seen in Maturity Onset Diabetes of Young (MODY) and even more rare in association with SGLT2i.Case history: 44 years female, genetically confirmed Hepatocyte Nuclear Factor 1 alpha (HNF1A) MODY since 2004 initially treated with maximum doses of metformin and gliclazide and then lost to follow-up. GP initiated Empagliflozin a year before presen...

Background: People wanting to access gender affirming hormone therapy (GAHT) as part of gender affirming treatments are increasing in number and often face long waiting lists. Nationally there is often limited and inconsistent endocrine support for this group. As a result people often feel unsupported and confused in their treatment journey. (In 2019 we set up a dedicated endocrine clinic within the Grampian GIC (gender identity clinic), with the specific remit to see all peop...

Introduction: Vitamin D deficiency is known to cause adverse outcomes in pregnancy and has shown to have an association with Gestational Diabetes Mellitus (GDM)Aim: To evaluate the relationship between GDM and Vitamin DMaterials and Methods: In a retrospective study we explored the Vitamin D levels (Sufficient >50nmol/l - G1, Insufficient 25-50nmol/l - G2, Deficient <25nmol/l - G3), GTT results, diabetes status and pregnanc...

Background: Hyponatraemia is the most common electrolyte abnormality encountered in hospitals and has been independently associated with increased morbidity and mortality1. An appropriate work-up with guideline-based investigations and management is, therefore, crucial to allow accurate diagnosis and optimisation of patient care.Case Presentation: A 49-year-old with no significant past medical history presented with 2 weeks of persistent nause...

We adapted holistic needs assessment tool used in oncology setting to create a simple tool to assess the learning need of people with adrenal insufficiency. This simple tool consists of 17 items and it allows endocrine nurse educators to obtain a quick assessment on the self-care management knowledge and skill of people with adrenal insufficiency before embarking on adrenal education.The tool 17 items are:Understanding of adrenal i...