Endocrine Abstracts

A 24 year old gentleman presented following an episode where he became ‘sleepy’ and disorientated whilst driving and had to pull over. He was confused and lethargic and paramedics found blood glucose of 2 mmol/l. He gave a 3-week history of extreme lethargy, nausea, epigastric discomfort, blurring of vision and constant hunger. He denied recent weight changes and had no significant past medical/family history. Biochemical evaluation was as follows; Laboratory glucose...

Case history: Thyrotoxic periodic paralysis (TPP) which was first described in 1902 is characterised by episodes of painless muscle weakness, hypokalaemia and thyrotoxicosis without any total body potassium deficit. It predominantly affects people of Asian descent between 20 and 40 years old with a 2 percent incidence compared to 0.2 percent in non-Asian descent. The pathogenesis of TPP is related to an increase Na+/K+-ATPase activity in the skeletal muscle leading to an influ...

Grave’s disease is an auto-immune condition associated with hyperthyroidism caused by TSH-receptor antibodies (TRAB) expressed by follicular cells of the thyroid gland. Grave’s ophthalmopathy has been reported in 25% of the patients and is rarely associated with dermopathy and thyroid acropachy. Management is by anti-thyroid drugs, radioactive iodine ablation or surgery, either alone or in combination. We present a rare case of resistant Graves who has detectable ant...

Phaeochromocytoma is a catecholamine producing tumour arising from the adrenomedullary chromaffin cells. It produces hormones such as epinephrine, norepinephrine, catecholamine and dopamine. (1) There have been some case reports describing an association between Brown adipose tissue (BAT) accumulation due to catecholamine excess caused by a phaeochromocytoma. We present a similar case in this abstract. A 77 year old lady was referred to the community geriatricians with symptom...

We present a 41 years old lady who presented with non specifc symptoms- lethargy, general myalgia, memory impairment. She also complained of hot flushes, sweats and had a brief episode of panic attacks hence was commence on Sertraline by the GP. She has a past medical history of appendicectomy. Her mother had lymphoma and mother died from lung cancer. She is a smoker, however is teetotal. She has 3 children and works in a laundry. She was initially referred to the haematologis...

Background: Neuroblastomas are malignant tumors that arise from sympathetic plexus or adrenal medulla. Their clinical behavior can range from spontaneous regression to aggressive disease. Like paragangliomas, they have the capacity to secrete catecholamines and to express somatostatin receptors, which is important for diagnostic and treatment purposes. However, the differential diagnosis with paraganglioma can be challenging. We present a case of a catecholamine-producing tumo...

Von Hippel–Lindau (VHL) disease, attributable to germline mutations in the VHL gene on the short arm of chromosome 3 (3p25-26) is an inherited condition which can give rise to paragangliomas. We present a case of 47 year old gentleman with bilateral pheochromocytomas in the past resulting in both adrenalectomies as a child in the 1980. His routine follow up subsequently picked up elevated urine Normetanephrines at 14.3 µmol/24 h 25 years postoperatively. His CT abdo...

We present a case of a 24 year old lady with known SDHB mutation. She was referred from the genetics clinic in view of a strong family history of premature paraganglioma at the age of 17. On initial clinic assessment she exhibits no symptoms suggestive of paraganglioma or pheochromocytoma. Her blood pressure is normal at 120/75. pulse of 60–80bpm. Physical examination was unremarkable Her Plasma normetanephrine done on two separate occasion were elevated at 1600 pmol/l a...

Introduction: Differentiated thyroid cancer (DTC) prognosis is usually favorable, even when metastatic radioiodine avid disease is present. Radioiodine-refractory disease, usually a sign of higher aggressiveness, can be detected by 18F-FDG-PET/CT. There is a reverse relationship between iodine and FDG accumulation in thyroid cancer lesions, the so-called ‘‘flip-flop’’ phenomenon: when thyroid cancer cells dedifferentiate they tend to lose the...

Introduction: Hyponatremia is the most common hydroelectrolytic disturbance in clinical practice. Multiple causes exist for its occurrence, being the etiological diagnosis sometimes complex. In patients with suprasellar tumours it is even harder due to several confounding factors. Management of these patients is difficult as it conflicts with chemotherapy-associated hyperhydration protocols. We present a case that exemplifies this.Clinical case: Four yea...