Endocrine Abstracts

A 77 year old gentleman was referred to the endocrinology team following the incidental finding of an adrenal nodule on computer tomography (CT) colonography. Following this, dedicated CT of the adrenal showed a 4cm nodule with an attenuation of 30 Hounsfield Units. Biochemical investigation found no evidence of adrenal insufficiency or functional hormone production. Subsequent imaging by magnetic resonance imaging (MRI) and further CT showed stable appearances in size of the ...

Thyroid uptake scan is a widely used thyroid investigation that provides valuable information regarding the structure and function of the gland and helps in differentiating some of the common thyroid pathologies. We present a multicentre audit of thyroid uptake scans done for non-malignant thyroid pathologies and try to analyse the usefulness of this investigation in different situations.MethodsThis audit includes thyroid uptake sc...

BackgroundThyrotoxicosis with Graves’ Disease is treated with thionamide, radio-iodine treatment and thyroidectomy. Surgery is an important choice, especially when Graves’ Disease is complicated by thyroid orbitopathy. Pre- and post-operative protocols for thyroidectomy are imperative.Aims1) To assess pre-operative preparation of patients, with potassium iodide, vitamin D, beta blockade, and the pre...

Section 1: Case history: We present the case of a 21-year-old lady known to harbour a homozygous inactivating mutation of the calcium sensing receptor (CaSR) which led to uncontrolled hypercalcaemia in infancy, necessitating emergency total parathyroidectomy. The CaSR plays an important role in calcium homeostasis. Inactivating mutations result in a higher calcium “set-point” and various degrees of hypercalcaemia based on the severity of functional impairment. In the...

Section 1: Case history: A 50-year-old woman presented to the HIV clinic after suspecting adverse effects following two intra-articular triamcinolone injections to her left hip, administered three and seven months prior. She complained of ongoing leg pain, generalised weakness and lethargy. Her past medical history included HIV infection, mild asthma for which she took inhalers only and had never required oral steroids. Her antiretroviral medications included dolutegravir, dar...

Section 1: Case history: A 78 years old lady presented to Emergency Department with two weeks history of lethargy and confusion. She had background of advanced destructive Rheumatoid Arthritis diagnosed 30 years ago, multiple joint fractures, osteoporosis, long-term urinary catheter, recurrent UTI and renal calculi. She was recently discharged from hospital for urosepsis. She was bed-bound for the last 15 years after crushing vertebrae C2 C3 pressing on spinal cord. Her regula...

Background: X-linked hypophosphatemia (XLH) is a rare, hereditary, progressive musculoskeletal disorder. Prompt diagnosis and treatment in childhood ensures adequate bone matrix mineralization and skeletal growth. There is no consensus on indications for treatment in adult patients.Case Presentation: A 25 year old female was referred to endocrinology with a right ankle fragility fracture. She was known to have XLH, diagnosed in Poland at the age of 1 yea...

Background: Diabetes Insipidus (DI) is uncommon during pregnancy. It may predate pregnancy, be unmasked by pregnancy or arise de novo during pregnancy secondary to other pathology. We present a case of DI in pregnancy to highlight challenges in management.Case Report: A 27-year-old lady at 21 weeks’ gestation, presented to A&E with worsening headache and confusion for three to five months. She was hemodynamically stable, had bitemporal hemianopi...

Background: HDR syndrome also known by the eponym Barakat syndrome, is a rare, autosomal dominant disorder characterized by the triad of hypoparathyroidism, sensorineural hearing loss, and renal abnormalities. It is caused due to mutation (haploinsufficiency) in GATA3 gene on chromosome 10p with a wide spectrum of phenotypic variations.Case Presentation: A 33-year-old lady presented to emergency department with an episod...

The dexamethasone suppression test (DST) is a common screening test in Cushing’s syndrome but associated with false positive result in 10-20%. One cause of false positivity is inadequate dexamethasone absorption. An assay to measure serum dexamethasone concentration can be used to validate the accuracy of the DST result.Aims: To audit 1) Use of the dexamethasone assay in DSTs 2) How frequently dexamethasone levels are inadequate 3) ...