Endocrine Abstracts

A 74-year-old male presented with acute onset retro-orbital pain and nausea. He also complained of blurred vision and inability to open his left eye. There was no family history and the only past medical history was hypercholesterolemia treated with simvastatin. Clinical examination revealed a complete left ptosis, the left pupil was dilated with sluggish reaction to light and there was impaired adduction of the left eye. Visual fields and visual acuity were normal. Examinatio...

X-linked adrenoleukodystrophy (ALD) is a rare condition affecting the nervous system and adrenal cortex that typically presents in childhood. It results from mutations in the ABCD1 gene. We describe two cases of ALD presenting with hypoadrenalism in adulthood.A 20 year old man presented with persistent vomiting. He was pigmented, blood pressure was 100/60 mmHg, and neurological examination was normal. Investigations showed serum sodium 125 mmol/L, urea 1...

A 20 year old male presented with short stature (height below 3rd centile for age since aged 13 years) and lack of secondary sexual characteristics. Past history included repaired Fallot’s Tetralogy, sensorineural deafness, repaired cleft lip and palate, learning difficulties, possible unilateral coloboma, and surgery for undescended testes. There was no significant family history. Clinical examination revealed a BMI of 22.7 (height 1.68 m, weight 64 kg). He had a narrow ...

A 41-year old lady with hypothyroidism for 20 years attended the endocrinology clinic for persistently raised TSH levels despite high dose levothyroxine. Past medical problems – depression, psoriasis, obesity, cholecystectomy. Her hypothyroidism was well-controlled until 2016 but since then, her TSH concentration had risen significantly to >100 mU/l with normal free T4. Levothyroxine had been increased in steps to 200 mcg/day. Despite the increased dose, the TSH concentra...

The incretin hormone glucagon-like peptide-1 (GLP-1) has been proposed to increase beta cell mass, via effects on proliferation, apoptosis and neogenesis. However, the role of GLP-1 during normal human development is unclear. We have addressed this in human fetuses by quantifying GLP-1 secretion during fetal development and determining how GLP-1 signalling impacts on early human fetal pancreas in explant culture.GLP-1 is first secreted by the stomach, du...

A 32 year old Polish gentleman presented following a collapse with preserved consciousness. Preceding this he was noted to have had a rapid deterioration in mobility with worsening weakness in all four limbs. On further questioning the patient had been diagnosed with hyperthyroidism two months previously and was being treated with propylthiouracil. Positive examination findings included tachycardia with upper limb weakness with 2/5 power bilaterally and lower limbs weakness wi...

A 75-year-old female presented with increasing drowsiness and no other specific features. Past medical history included the antiphospholipid syndrome, three episodes of myocardial infarction, left ischaemic leg, epilepsy, hypothyroidism and splenectomy. Medications included warfarin. Examination showed pulse 70/min, blood pressure 120/60 mmHg, crepitations at the left lung base, a Glasgow Coma Scale 14/15. Investigations revealed serum sodium 117 mmol/l, urea 8.8 mmol/l, serum...

Adrenal haemorrhage is rarely associated with anticoagulation according to a large American series. We present 2 cases in whom there was no evidence of over anticoagulation, both of whom developed a degree of hypoadrenalism.Case 1: A 72-year-old-male presented with severe non-pleuritic left flank pain. He had been seen the previous day with possible deep venous thrombosis (DVT) and had received a single dose of enoxaparin (1.5 mg/kg). He was tender in th...

Radioactive iodine (RAI) has been in use for more than 60 years with satisfactory results RAI and safe profile, there has been a different outcome of treatment in different ethnic groups. We assessed the demographic features and clinical outcome of a Jordanian and British cohorts of patients treated with RAI.Methods: Hyperthyroid patients who opted RAI as a primary therapy and those who had relapse after treatment with antithyroid drugs (ATD) or h...

Objectives: There is strong epidemiological evidence that insulin resistance confers a significantly increased risk of cardiovascular disease independent of other cardiovascular risk factors. The aim of the study is to compare the insulin resistance levels in metabolic syndrome of polycystic ovarian syndrome (PCOS) with that of type 2 diabetes (T2DM).Methods: The biological variation of IR was assessed by measuring IR at four day intervals on 10 consecut...