Endocrine Abstracts

The low dose dexamethasone suppression test (LDDT) is used routinely to exclude Cushings. This test can also be used to exclude androgen secreting tumours in females with elevated testosterone levels through normalisation of, or >40% suppression of serum levels.We have audited the use of the LDDT to assess its value in investigating women with raised androgens, to ascertain whether it reduced the need for other investigations and to identify any prob...

Background: Increasing numbers of children and adults are surviving cancer and living with the consequences of their disease or its treatment. The commonest long term consequences observed following childhood cancer are endocrine and there is a growing body of evidence indicating that adults treated for malignant disease are also at risk of endocrine dysfunction.Aim: To determine the involvement of Endocrinologists in the management of cancer survivors a...

Background: Clinical experience has shown that men over 60 years of age frequently (40%) require extended intervals of greater than 12 weeks between administrations of Nebido. No work has assessed whether this is specific to men over 60 years of age.Methods: We analysed men on Nebido over 60 years (n=12, mean age 66 years) and compared them with a BMI matched group aged 40–60 years. We assessed testosterone levels, injection intervals, PSA an...

A 45 year old female civil servant presented to primary care for a routine evaluation of her lipid profile. When questioned, she described a history of lethargy and low mood. The patient’s GP noted features of agitation and sweating and organised a range investigations including thyroid function tests. Past medical history included systemic lupus erythematosus, a diagnosis that the patient had experienced difficulty accepting, requiring an extended period of counselling.<...

A 44-year-old lady with hypertension and type 2 diabetes of 10 years duration (BMI 47, HbA1c 9.1%) treated with metformin and exenatide presented with a few days history of feeling generally unwell, vomiting and confusion. Initial examination showed pulse 120 per min, BP 115/74 mmHg, normal temperature and multiple abdominal striae. Admission investigations showed Na 140, K 1.4, urea 3.9, creatinine 74, glucose 26, CRP 23 Hb 16.2, WBC 11.6. ABGS on room air showed pH 7.41, PCO...

Introduction: Hyperthyroidism secondary to Graves’ disease is well-recognised to be associated with non-thyroidal immunological manifestations like ophthalmopathy and pretibial myxoedema. We report a patient with Graves’ disease who presented with an unusual complication.Case: A 68 year old Caucasian lady presented with typical features of hyperthyroidism which was confirmed by free T4 72.0 pmol/l (12.0–22.0 pmol/l) and TSH <0.01 mU/l ...

Background: Radioactive iodine (RAI) therapy effectively cures hyperthyroidism although a varying proportion of patients need repeat RAI doses. There is no consensus on the timing of redosing for RAI which varies in different centres between 6 weeks and 12 months depending on the perceived time to respond to therapy.Aim: We have undertaken a retrospective study to assess if after the initial RAI dose of 400 MBq a second RAI dose can be administered earli...

Background and aim: Fixed dose radioiodine therapy (RAI) is considered to be the standard regime for management of hyperthyroidism although the actual RAI activity used varies between different centres. We have undertaken a retrospective comparison between various outcomes achieved following the use of fixed RAI doses of 400 and 550 MBq at two different centres.Patients and methods: An electronic database has been prepared for all patients who receive RA...

Background: Urinary catecholamine measurement has been the mainstay for diagnosis of a phaeochromocytoma. Plasma metanephrine estimation has been introduced more recently although its precise position remains unclear. We have undertaken a retrospective analysis of patients who have undergone this test to assess its usefulness in the diagnostic process.Patients and methods: We evaluated all patients who have had plasma metanephrine estimation over the pas...

Case: Twenty seven year old male presented to Urologist with heamospermia. He wa noted to have a lump in his scrotum. No evidence of infection. Ultrasound showed bilateral testicular tumours. Previous medical history of congenital adrenal hyperplasia and hypertension. Medication include Atenolol and Prednisolone (poor compliance). Non smoker. Very strong family h/o cancer. O/E bilateral upper pole testicular lumps 2 cm. firm, irregular. Tumour markers normal. All blood tests n...

Introduction: Within the setting of putative or established pituitary disease the primary disease process (i.e. Cushing’s disease), hormone deficits (i.e. sex steroids, GH), and inappropriate replacement therapy (i.e. glucocorticoids) are reputed to predispose to low bone mass.Patients and Methods: We examined bone mass at the lumbar spine (LS) and total hip (TH) using DXA in 259 patients with an insult to the hypothalamo–pituitary axis (51.6&#...

Back ground: Radio iodine treatment is widely used in the management of hyperthyroidism. Recent guidelines have stressed the importance of advising patients of the recommendations with regard to radiation protection, and the implications of radioiodine treatment in relation to work, travel and contact with the family. We carried out a survey to assess our joint radioiodine clinic approach where all patients referred for treatment are assessed jointly by a consultant endocrinol...

In a retrospective study, we studied the medical notes of 35 patients with adrenal insufficiency; aged 61±15 (mean ±S.D.) years. Their average age at diagnosis was 45±18 years, and duration of the disease was 17±15 years.Most patients were on hydrocortisone replacement (32 patients); taking 23±4 mg daily in divided doses, and only 3 (9%) patients were on single dose of prednisone 7.5±05 mg daily in a single do...