Endocrine Abstracts

Background: Falls are a significant health problem and major burden on healthcare services. Falls are typically associated with ageing-related frailty, but diabetic peripheral neuropathy, postural hypotension and hyponatraemia are recognised risk factors for falling that might be independent of ageing-related factors. We undertook a study to assess the prevalence of these independent risk factors in patients admitted to hospital following a fall.Methods:...

Fetal growth restriction (FGR), which describes the failure of a fetus to achieve its genetic growth potential, not only increases the risk of perinatal mortality and morbidity but also predisposes to metabolic disease in adulthood. In developed countries, FGR is typically attributed to dysfunction of the placenta – a transient organ that mediates nutrient supply, eliminates waste, and protects the fetus from maternal immune response. The placenta also functions as a majo...

Background: Local guidelines for infants born to mothers with a history of thyrotoxicosis previously recommended that infants were observed in hospital until thyroid function tests were checked on day 4, with follow up on day 10, causing inconvenience to families and unnecessary cost to services. Following a literature search, our revised local guidelines recommend low-risk infants can be discharged on day 0 without follow up, stratified using maternal TSH-receptor antibody (T...

Opioids –Yet another Cause for Adrenal Insufficiency. Opioid prescriptions have almost doubled in the last decade in the UK. Opioid related hypogonadotropic hypogonadism is a well-recognised clinical entity. Opioid therapy as a cause of adrenal insufficiency is an under-recognised endocrinopathy with potentially lifethreatening adverse effects. We present the case of a 57 year old lady referred to the endocrine clinic with symptoms of generalised fatigue and weakness. Her...

Background: Functional hypothalamic amenorrhoea (FHA) is a common cause of secondary amenorrhoea and is related to a combination of weight-loss, exercise and psychological stressors. These factors lead to suppression of pulsatile GnRH secretion. Diminished LH and FSH concentrations result in a hypoestrogenic state. We present an archetypal case of FHA that clearly demonstrates the ‘hypothalamic set-point’ for the body composition of a young woman below which...

Case history: A 72 year old gentleman from Zimbabwe presented to clinic with MRI pituitary findings of 1.5×1.4×1 cm pituitary macroadenoma. This had been discovered incidentally during outpatient investigation for severe headaches refractory to standard analgesia at another hospital. The mass was in contact with but not compressing the optic chiasm. He did not describe any visual loss. He had an unintentional weight loss of 10 kg in the last 2 months. He described de...

Hypothyroidism is a recognised late complication of radiotherapy to the neck. However, radiation-induced thyrotoxicosis is not generally considered, and may not be diagnosed. We report a case of transient thyrotoxicosis following radiotherapy to the neck. A 71-year-old man with supraglottic squamous cell carcinoma was treated with 65Gy radiotherapy, delivered by volumetric arc therapy in 38 fractions. During radiotherapy he became confused. Three days af...

We report a case of acute adrenal crisis in a patient with the antiphospholipid syndrome in a man who was on a therapeutic dose of warfarin. A 64-year-old man presented with vomiting and abdominal discomfort. Temperature was 37.8 °C, pulse 85/min and BP 100/63 mmHg. On examination, there was generalized hyperpigmentation. He had a history of deep venous thrombosis of the lower limbs on two occasions and was on warfarin. He previously diagnosed primary antiphospho...

Adrenal gland anomalies are common incidental findings when imaging tests are performed for other reasons, but are usually unilateral. We present a case where bilaterally abnormal adrenal glands held the key to a rare diagnosis. A 79 year old female ex-smoker with a background of Type 2 Diabetes Mellitus and hypertension presented to our emergency department with a four month history of falls and progressive decline in mobility. Examination revealed evidence of weight loss, wi...

Background: Thyroid carcinoma consists of just 1% of all malignancies but is the commonest malignant endocrine tumour. Papillary thyroid carcinoma is the most common form of thyroid carcinoma consisting of 80% of all cases. There are very few case reports in the literature of papillary thyroid cancers presenting with distant to the pelvic organs. Distant metastases are noted in 1–3% of patients with thyroid cancer at initial diagnosis.Clinical case:...