Endocrine Abstracts

A 29 year old woman with multiple sclerosis and no history of thyroid dysfunction was referred to endocrinology with T3 thyrotoxicosis (TSH <0.01 mU/l, fT4 20.7 pmol/l, T3 2.9 nmol/l). She had received monoclonal alemtuzumab therapy 9 months prior. This hyperthyroid phase was short lived and in the absence of anti-thyroid medication developed symptomatic hypothyroidism within 2 months of referral (TSH 52.9 mU/l, T4 <5 pmol/l, T3 0.8 nmol/l). Thyroid receptor antibodies...

A 47-year-old Caucasian gentleman was diagnosed with diabetes mellitus in September 2019. He presented with blood glucose 29.5 mmol/l and negative ketones in December 2020 and was treated with variable rate insulin infusion. He had short stature with height of 161 cm and weight 53.5 kg (BMI 20). There was mild weakness of quadriceps (4/5). Laboratory tests revealed high lactate (5.38 mmol/l) and HBA1c (70 mmol/mol), reduced eGFR (47 ml/min) and negative antibody. He had gradua...

A 31 year-old woman is referred into the Endocrine clinic with a palpable mass in her right anterior neck that was found incidentally by her GP. She had no known past medical history, did not take any medications and had not noticed any dysphagia, neck pain, or compressive symptoms. On clinical exam, there was an enlarged thyroid with a 1.5-cm left-sided thyroid nodule that moved on swallowing. There was no palpable cervical lymphadenopathy. TSH was 2.5 mIU/l (0.29–5.1 mI...

Background: Hashimoto’s thyroiditis and Grave’s disease are the common autoimmune diseases of thyroid gland across all age groups. Some patients with autoimmune hyperthyroidism can become hypothyroid however it is rare for patients with hypothyroidism to develop Grave’s disease. Although some cases have been reported in adults, this phenomenon is very rare in the paediatric age group. Case: 13 year old Caucasian girl who was diagnosed with...

Introduction: Klinefelter Syndrome (KS) is related to late puberty and infertility. Early puberty in KS is a rare occurrence; a case of early puberty in KS is presented.Case report: A 10-year old boy, diagnosed with KS (47,XXY) during investigations for learning difficulties, was referred to the endocrine clinic with a history of facial acne since the age of 8 years. His examination showed pubic hair (stage 3) with testicular volume 4–5 ml on both s...

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Adrenal insufficiency is an uncommon endocrine condition with an incidence of 4 cases per million. Common non-iatrogenic causes include autoimmunity, infections and infiltrations. We describe a case of acute adrenal insufficiency secondary to an unusual cause.A 77-year old female was admitted under the surgeons with abdominal pain and pyrexia. Abdominal ultrasonography showed large stones within a thickened gallbladder and a pr...

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Adrenal insufficiency is an uncommon endocrine condition with an incidence of 4 cases per million. Common non-iatrogenic causes include autoimmunity, infections and infiltrations. We describe a case of acute adrenal insufficiency secondary to an unusual cause.A 77-year old female was admitted under the surgeons with abdominal pain and pyrexia. Abdominal ultrasonography showed large stones within a thickened gallbladder and a pr...

Introduction: Underlying causes of short stature are difficult to establish and many patients with short stature do not have a clear diagnosis. Careful examination and investigation of patients with short stature may identify additional features that help to make a diagnosis or direct genetic testing. Here we describe a patient with severe short stature with additional features on examination and skeletal survey in keeping with KBG syndrome. In addition, the patient developed ...