Endocrine Abstracts

Optimal management of familial medullary thyroid cancer (MTC) involves early genetic diagnosis of affected individuals and prophylactic thyroidectomy. Patients diagnosed later may have biochemical evidence of metastases which are clinically silent. We report a family which illustrates the management difficulties which may arise with this approach. SC, a healthy 25-year-old man, presented for assessment for MTC. His mother had had a total thyroidectomy for MTC with no clinical ...

Growth hormone (GH) replacement in GH-deficient adults exerts clear effects on body composition, but there is a lack of high-quality evidence concerning its functional effects which may be clinically more important. This meta-analysis is carried out to determine the effects of GH replacement on exercise performance. A Medline search and examination of reference lists of included studies and relevant review articles identified 11 studies with utilizable, robust data, involving ...

Adrenal/periadrenal sarcomas are very rare entity of adrenal tumours. An epidemiological analysis of primary adrenal cancers found prevalence of adrenal sarcoma of 1.3% compared to adrenocortical carcinoma (ACC) 43.8%, neuroblastoma 39.7%, pheochromocytoma 10.9% and non-Hodgkin’s lymphoma 4.3% (1). In 2021, 26 adrenalectomies in adults were performed in our institution. 12/26 had malignant histology. 9/26 lesions were > 6 cm. 7/9 lesions > 6 cm were malignant (2 a...

Case history: 73-year-old male was seen in breast clinic for right breast lump which was noted 6 weeks back with no nipple discharge. Mammogram and ultrasound confirmed bilateral gynaecomastia more on right side. Referred to endocrine clinic with abnormal hormone profile. He is a retired builder. He was a heavy smoker for 50 years and has stopped smoking 1 year back. He drinks socially and has never used illicit drugs. His only past medical history was GORD for which he takes ...

Introduction: Cardiovascular manifestations of hypocalcaemia include reversible CHF, prolonged QTc and ventricular arrhythmias. In patients presenting with hypocalcaemia, diagnosis of hypoparathyroidism is straightforward, but determining its cause is challenging.Case Report: 33 year lady admitted (23 November 2018) with VF arrest. Bloods showed low calcium (1.62 mmol/l), magnesium (0.48 mmol/l) and potassium (2.3 mmol/l) and ECG showed prolonged QTc. PT...

Introduction: Thyroid Hormone Resistance (THR) is a rare disorder caused by mutations of Thyroid Hormone Receptor characterised by insensitivity of target tissues to thyroid hormone actions. Patients can present with hyperthyroidism or hypothyroidism symptoms.Case report: 49 year lady with recurrent thyrotoxicosis with goitre (1989/1994/1998) treated elsewhere with CBZ/PTU and RAI (2001). She developed post-RAI hypothyroidism and at presentation to our O...

Introduction: Hypothyroid patients with failure to take/absorb oral levothyroxine might require intravenous levothyroxine. IV levothyroxine is neither licensed nor available in UK. It has to be imported (with special request), and is unexpectedly costly. IV liothyronine has shorter duration of action, need 2–3 injections/day, and exhibits sudden surges increasing risk of angina/arrhythmia. Moreover, IV liothyronine is much more expensive than IV levothyroxine.<p class...

A 65 yo gentleman was referred to the endocrinology department with thyrotoxicosis. He had a history of IHD and recurrent VT necessitating amiodarone for 8 years. Routine TFTs had shown TSH undetectable, fT4 34.1, fT3 8.7. There were no symptoms or signs of thyrotoxicosis or cardiovascular compromise. He had been treated with carbimazole by his GP for the previous 3 weeks, this was discontinued at the initial evaluation due to recurrent vomiting. TPO anti...

We describe below a 72-year-old woman who presented clinically with short metacarpals and metatarsals and the following blood biochemistry: corrected calcium of 2.16 mmol/l (normal: 2.05–2.60), phosphate 0.61 mmol/l (normal: 0.8–1.45) and alkaline phosphatase of 108 U/l (normal: 35–104). She was 153 cm tall and weighed 109 kg with a round face. She had a history of Monoclonal Gammopathy of unknown significance, vitamin B12 deficiency and was admitted 10 years ag...

We conducted a prospective audit of triple therapy in type 2 patients (Dec01 to Dec02). 51 patients on maximal Metformin and sulphonylurea had a Glitazone added. 11 patients were lost to follow up. The remaining 40 patients, 23 Male, 17 Female, mean age 51years (35-66), diabetes mean duration 8.5 years (2-16) had a mean BMI of 33.8 (range 22-47). Mean baselineHbA1C was 9.6% (7.3-12.3%).Parameters measured were blood pressure, height, weight BMI, full blo...