Endocrine Abstracts

Radioactive iodine is used routinely and safely in the treatment of hyperthyroidism. We describe an unusual side effect after a single treatment in a patient with subclinical hyperthyroidism.A 64 year old woman was referred to our service with multinodular goitre. She was found to have subclinical hyperthyroidism with TSH 0.17 mU/L, fT3 5 pmol/L and fT4 14 pmol/L. She underwent radioactive iodine treatment with 530 MBq of Iodine -131 in Jan...

A 39-year-old lady with background history of autoimmune hypothyroidism diagnosed over 10 years ago, established on Levothyroxine 100 mg once daily, was referred by the GP with unusual sweating, palpitations, tiredness, anxiety, tremors and weight loss of around one stone over last few months. The thyroid function tests were suggestive of thyrotoxicosis with TSH of less than 0.05 mu/land FT4 60 pmol/l, hence the dose of levothyroxine was gradually reduced and ultimately stoppe...

We report two cases of severe hypocalcaemia developed after intravenous administration of pamidronate in patients with severe hypercalcaemia secondary to multiple myeloma. Both of them develop symptomatic hypocalcaemia few days after treatment. Both patients was probably vitamin D deficient (both serum 25-hydroxyvitamin D level was low less than 15 (NR 25–120 nmol/l) because of a combination of poor oral intake, inadequate sunlight exposure, and the development of renal f...

Background: Thyrotoxicosis can present as heart failure, especially in elderly patients. We report a case of thyrotoxicosis causing reversible right-sided heart failure.Case: A 75-year-old Caucasian lady presented with a month’s history of shortness of breath, abdominal distension and ankle oedema. She complained of hot sweats with palpitations, On admission, she was thyrotoxic with evidence of severe right sided heartfailure.Her ECG showed fast atr...

We had a 29 year old lady with 11 years history of hirsutism and amenorrhoea. She was diagnosed as polycystic ovarian syndrome in a different hospital few years ago and commenced on metformin and spironolactone. She noticed worsening of hirsuitism over last year, needing to shave daily, along with loss scalp hair, deepening of voice and clitoromegaly. On examination, she was obese without any overt signs of Cushing’s syndrome. She had severe hirsuitism affecting face, arm...

We had a 67-year-old lady who presented with 2-week history of shortness of breath and dry cough. Her past medical history includes dense left sided hemiplegia from previous stroke, hemiarthroplasty for fracture neck of femur, hypertension and osteoporosis. She had a large goitre for many years without any recent change in size of the goitre and there was no history of dysphagia. She had a large goitre with engorged neck veins, but no palpable lymph nodes. Her Chest X-ray show...

Young man with high BMI and known iatrogenic hypothyroidism, post radioactive iodine (RAI) treatment (2015) for Graves’ thyrotoxicosis (2011) was referred to endocrinology due to significantly raised TSH (at 50 mu/l) and low FT4 (5.0 pmol/l). He was actually admitted with progressive nausea, vomiting over last three weeks. He also complained of abnormal stool consistency (like semi-solid) intermittently. His past medical history also includes gastric bypass with gastro-je...

Langerhans cell Histiocytosis is a rare neoplastic histiocytic disorder. It has broad spectrum of clinical presentations from single system to multi system. It mainly affects children but can occur in adults. It can present with skin lesions, skull/jaw tumours, polyuria/polydipsia, fever, cough and dyspnea, bone pain, ataxia etc. 25% of adult cases involve Pituitary (anterior and posterior pituitary gland) and hypothalamus. BRAF and MAP2K1 mutations are most ...

Section 1: Case history: A 51-year-old lady was referred to our endocrinology clinic with a 6-month history of palpitations, generalized muscle aches, heat intolerance, increased sweating and significant unintentional weight loss. She is normally fit and well without any significant past medical problem. Her thyroid function tests showed thyrotoxicosis picture with TSH < 0.05 miu/L, Free T4 76pmol/l, Free T3 > 30.8 pmol/l with positive TSH receptor antibodies ( 34.9U/L...

Thyroid storm is a rarely seen complication of Thyrotoxicosis complicated by multiple organ dysfunctions. Early recognition is crucial in reducing morbidity and mortality. We present the case of a young lady admitted with traumatic fracture of Tibia and Fibula. She was noted to be in rapid AF and on examination manifested signs of Thyrotoxicosis with palpable goitre. She was noted to be hyperthermic and emotionally labile and confused with signs of right heart failure.Investig...