Endocrine Abstracts

Background: Adrenal incidentalomas are common amongst the general population, incidence increases with age. Radiological and biochemical assessment of all lesions >1 cm is standard practice to determine appropriate future management, as per current European guidelines. We report the experiences of a recently formalised adrenal multi-disciplinary pathway in a large UK teaching hospital, where all adrenal incidentalomas are referred and systematically assessed.<p cl...

A 26-year-old Caucasian female presented at 14 weeks gestation with a 6-week history of lethargy, nausea and vomiting during her first pregnancy. Her adjusted Calcium was 4.12 mmol/l and parathyroid hormone (PTH) 26 pmol/l, consistent with possible primary hyperparathyroidism. She was previously well apart from occasional migraines. There was no known history of familial hypercalcaemia or MEN. Other biochemistry results revealed hypokalaemia of 3.2 mmol/l, low vitamin D at 16 ...

Background: Thyrotoxicosis is one of the commonest endocrine disorders and its severe form can manifest as thyroid storm in acute setting leading to organ dysfunctions including heart failure. Cases: 1: A 58-year-old female with a significant past medical history of MI, paroxysmal AF/atrial flutter, and hyperthyroidism presented with a one-week history of palpitations, plethora, diaphoresis, heat intolerance, loose stools, and a TSH <0.01; Free T4-33...

Introduction: BONJ is a recognised complication of bisphosphonate treatment (both oral and intravenous). Data are sparse with the reported incidence of BONJ in the oral treatment of osteoporosis between 0.01% to 0.067% or alternatively described as 1.04 to 69 per 100,000 patient-years. This study aimed to estimate the incidence of BONJ in patients taking oral bisphosphonates as a treatment for osteoporosis.Methods: Forth Valley Hea...

Introduction: BONJ is a recognised complication of bisphosphonate treatment (both oral and intravenous). Data are sparse with the reported incidence of BONJ in the oral treatment of osteoporosis between 0.01% to 0.067% or alternatively described as 1.04 to 69 per 100,000 patient-years. This study aimed to estimate the incidence of BONJ in patients taking oral bisphosphonates as a treatment for osteoporosis.Methods: Forth Valley Hea...

Section 1: Case history: A 68 year old lady presented with a 2 week history of pedal swelling, with large blisters appearing on her feet. Her past medical history included adrenal Cushing”s treated with a right laparoscopic adrenalectomy on a 4.7x5.2 cm lipid poor adenoma 12 years previously; she had been discharged 7 years ago after repeated normal overnight dexamethasone suppression tests. Over the last year she had gained 12 kg in weight and been diagnosed with type 2 ...

Background: Children with undiagnosed coeliac disease are at risk of low bone mineral density (BMD), but whether this translates to fracture predisposition is unclear. In adults with coeliac disease anti-osteoprotegerin (anti-OPG) antibodies have been identified. OPG inhibits RANK ligand activation of osteoclastic bone resorption, and thus anti-OPG antibodies promote bone loss. We report a case of osteoporosis with elevated anti-OPG antibodies in a child with coeliac disease.<...

Diabetes mellitus education for children, young people and their families has become more complex in recent years, requiring a solid knowledge of mathematics, problem solving and ongoing adjustments as the child grows. The education at time of diagnosis can be overwhelming for many parents who are coming to terms with this lifelong condition. But we, as diabetes teams also expect them to take on new and alien tasks, not only blood glucose testing and injecting insulin, but als...

Background: A quarter of UK children now leave primary school obese. Childhood obesity is associated with significant comorbidity including obstructive sleep apnoea, type 2 diabetes, non-alcoholic fatty liver disease, hypertension and depression. We report our experience of using semaglutide, a weekly subcutaneous GLP1 receptor agonist, as a weight-loss adjunct for severely obese children in combination with dietary and lifestyle support from a multidisciplinary team.<p cl...

Section 1: Case history : The case concerns a 53-year-old gentleman who developed calciphylaxis following a bioprosthetic aortic valve replacement. His past medical history included Multiple Endocrine Neoplasia Type 1 (MEN-1) for which he had previously undergone total parathyroidectomy with failed graft auto-transplantation. The resulting hypoparathyroidism was managed with alfacalcidol and calcium supplements. Post cardiac valve replacement he developed acute renal injury an...