Endocrine Abstracts

We present a 20-year-old lady who was known to have MEN-1 and had previously been treated for hyperparathyroidism at a different hospital in 2003 with excision of right upper and lower and left lower parathyroid glands and left thyroid lobectomy, resulting in normalisation of adjusted calcium (adjCa) levels.She presented to our department with persistently elevated adjusted calcium levels (adjCa 2.69 mmol/l) along with raised parathyroid hormone (PTH 16 ...

Background: Adrenal incidentalomas are common and require investigation to exclude malignancy and evidence of hormone overproduction. Prospective screening programmes are essential for early detection of cancer but often lead to incidental findings which have potential health economic implications and may increase patient anxiety. With regards to investigation of incidental adrenal nodules, current national lung cancer screening recommendations are not in keeping with current ...

A 21-year-old man presented with 2 months history of weight gain, acne, hirsutism, lethargy, and muscle weakness. Examination revealed that he was cushingoid in appearance, had pustular acne and proximal myopathy. Initial 24 h urinary free cortisol was significantly raised at 5320 nmol/day (10–147), with raised ACTH of 120 ng/l (<47). He failed to suppress his cortisol on the low dose dexamethasone suppression test (baseline 708 nmol/l and 48 h 706 nmol/l). Urinary an...

We describe a 91 year old woman who presented to hospital with transient loss of consciousness resulting in facial trauma. In the preceding 6 weeks she described 2 similar episodes of loss of consciousness and general malaise. She had a past medical history of pulmonary hypertension secondary to recurrent pulmonary emboli. Relevant medication included furosemide 20 mg od and life-long warfarin.On examination she had significant orbitofrontal bruising and...

23-year-old woman presented with rapid cycling bipolar disorder (RCBPD) with alternating episodes of mixed affective states, hypomania & severe depression. Quetiapine was initiated & discontinued due to side effects. Levothyroxine was started & gradually increased to 500mcg daily. This was coupled with 6 weeks of low frequency (LF) rTMS. She was clinically euthyroid. TSH <0.01 miu/l (0.27–4.2), fT4 37.1 pmol/l (12–22), fT3 8.4 pmol/l (3.1–6.8), r...

Background: The exponential growth of social media over the last decade has provided new, diverse and accessible ways in which people can share and receive information. Its rapid rise has attracted researchers and professionals of various disciplines, aiming to capitalise on this relatively new phenomenon. In this qualitative study we utilised social media to conduct research on psychosocial aspect of acromegaly. Facebook currently has 845 million users. Acromegaly, with a pre...

Background: Adrenal incidentalomas are common and require investigation to exclude malignancy and evidence of hormone overproduction. Clinical guidelines recommend overnight dexamethasone suppression tests (ONDST) to assess for cortisol hypersecretion with cortisol levels of 50-138 nmol/l termed “mild autonomous cortisol secretion” (MACS). MACS may be associated with both cardiovascular and metabolic morbidity. We assessed cardiovascular risk in patients with MACS us...

Background: Adrenal incidentalomas are common amongst the general population, incidence increases with age. Radiological and biochemical assessment of all lesions >1 cm is standard practice to determine appropriate future management, as per current European guidelines. We report the experiences of a recently formalised adrenal multi-disciplinary pathway in a large UK teaching hospital, where all adrenal incidentalomas are referred and systematically assessed.<p cl...

In patients presenting with a diffusely enlarged hard thyroid gland the differential diagnosis lies between thyroid carcinoma, lymphoma, and Riedel’s thyroiditis. We present a case of Riedel’s thyroiditis with multifocal nodular sclerosis, which improved with levothyroxine replacement.A 40-year-old woman presented with a 3 months history of neck swelling, dysphagia and breathlessness on exertion. Examination revealed a hard, fixed, diffuse goit...

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...