ECE2018 ePoster Presentations Diabetes, Obesity and Metabolism (56 abstracts)
Type 2 diabetes: an unexpected journey
Yasmin Nikookam 1 , Caoimhe Bonner 1 , Bonnie Grant 1 , Anthony Pittathankal 1, , Dhafir Al-Okati 1, , Imran Syed 2 , Edel Casey 1 & Khash Nikookam 1,
1Barking Havering and Redbridge University Hospitals NHS Trust, Greater London, UK; 2Spire Roding Hospital, Greater London, UK.
We report a case of a well 40 year old gentleman who self-referred for confirmation of diagnosis of diabetes. On further history he had been informed by other healthcare professionals the possibility of diabetes based on his elevated fasting serum glucose of 13.8 mmol/L and HbA1c of 81mmol/mol with no osmotic symptoms. His triglyceride was also elevated at 12.26 with rather variable compliance to statin. Examination of all systems were unremarkable, however on neck examination both thyroid lobes were palpable. Right lobe felt irregular and nodular, and left lobe smooth. It was rather difficult to palpate the lower pole of the thyroid lobes. No thyroid or carotid bruits audible; no lymphadenopathy felt. The patient was clinically euthyroid. Ultrasound of neck and thyroid was arranged and showed pathological level III lymph nodes and an indeterminate hypoechoic left thyroid nodule with possible areas of microcalcification; U3 thyroid nodule. Subsequently, an MRI of the neck confirmed a single morphologically abnormal lymph node at level IV on the right. FNA of the left thyroid nodule was suspicious of papillary neoplasia and FNA of the right cervical node was suggestive of metastatic carcinoma. The patient underwent a total thyroidectomy with an uneventful recovery. He was commenced on thyroxine and calcichew D3. He is awaiting I131 therapy. This case emphasises thorough history and examination is crucial for patients wellbeing which may well improve comorbidities and prolong one’s life.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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