Endocrine Abstracts

A 59-year-old gentleman presented to the Medical Admission Unit with facial and ankle oedema following a dog bite. He did not have any significant past medical history. Initially, he was treated for angioedema. His oedema worsened to anasarca, blood pressure rose and was found to be hypokalaemic. Echocardiogram showed a normal left ventricular ejection fraction. Urine protein creatinine ratio was <0.5 g/24 h. Vasculitic and autoimmune screen were negative. Eight weeks late...

Although pituitary abnormalities are the most commonly reported endocrine feature in septo-optic dysplasia, other endocrine abnormalities have not been described so far. We present a case of septo-optic dysplasia (SOD) and pituitary dysfunction, complicated by X-linked adrenoleucodystrophy (X-ALD) and primary adrenal insufficiency.A 4-year-old boy was referred with hypoglycaemic episodes and seizures during intercurrent illnesses. He had a history of pol...

Background: MBDP describes inadequate mineralisation of bones in the preterm infant. Traditionally, neonatologists have used a raised ALP and low phosphate to diagnose MBDP, with phosphate supplements as first-line treatment. An alternative management approach, published by Chinoy et al (2019), recommended PTH and vitamin D in the routine work-up. Objectives: We undertook a review of data across two neonatal intensive care units:<p class="ab...

A 56-year-old male presented in 2017 with acute symptomatic hyponatraemia. He was admitted with a seizure and a plasma sodium of 112 mmol/l. His past medical history was notable for alcohol excess and smoking. The acute presentation was managed with 3% hypertonic saline infusion in ITU. Plasma osmolality was 240 mOsm/Kg, urine osmolality 327 mOsm/kg and sport urine sodium 28 mmol/l. CT TAP showed some oesophageal thickening only; endoscopy was normal. He made a good recovery f...

A 63-year old woman presented with a 3 weeks history of sweating, panic attacks and vomiting. Urine dipstick on admission was positive for glucose (3+) and ketones (2+) and lab glucose was elevated at 26 mmol/l. Based on the findings she was treated as diabetic ketoacidosis and commenced on insulin. Further investigations showed an elevated urinary catecholamines and marked hypercalcaemia (adjusted calcium 3.10 mmol/l) with unsuppressed PTH at 71 pg/ml (normal 12–72 pg/ml...

We present a case of a 76-year-old Caucasian woman with combined primary hypoparathyroidism and vitamin D deficiency resulting in life-threatening hypocalcaemia.She has a history of COPD and initially presented in 2002 with an exacerbation of her airways disease. During treatment for her condition an incidental note was made of hypocalcaemia (calcium 1.62 mmol/l). PTH was minimally elevated at the time but 25-hydroxycholecalciferol was low (4.2 ng/ml). S...

Background: Thionamides are a safe and effective treatment for Graves’ thyrotoxicosis and tend to be favoured over radioiodine in the UK. Risk of recurrence following cessation of thionamides is high although most studies tend to have short duration of follow up. We have previously published follow-up data to 4 years in this cohort and now present follow-up out to 7 years.Methods: Retrospective review of first presentation Graves’...

Background: Thionamides are a safe and effective treatment for Graves’ thyrotoxicosis and tend to be favoured over radioiodine in the UK. Risk of recurrence following cessation of thionamides is high although most studies tend to have short duration of follow up. We have previously published follow-up data to 4 years in this cohort and now present follow-up out to 7 years.Methods: Retrospective review of first presentation Graves’...

Case history: A 59 year old Afro-Carribbean male with a 25 year history of cardiac enlargement and hypertension, on multiple anti-hypertensives, presented with increasing breathlessness and several years of markedly reduced exercise tolerance. He was intolerant of spironolactone and eplerenone. His past medical history included hypertersion, obstructive sleep apnoea, Steven-Johnson syndrome secondary to allopurinol, thyrotoxicosis treated with radio-active iodine, monoclonal g...

The thyroid gland functions in supplying thyroid hormones (TH) to the body periphery, which is enabled by cathepsin-mediated thyroglobulin proteolysis and TH translocation across membranes by the Mct8, Mct10, and Lat2 transporters. Previously, we showed that cathepsin K-deficient mice feature normal thyroid phenotypes which is, in part, due to the functional compensation through cathepsin L upregulation that is independent of the classical hypothalamus–pituitary–thyr...