Endocrine Abstracts

Prior to therapy, patients choosing I131 therapy for the treatment of Grave’s disease were pre treated with carbimazole. Post I131 they have their thyroid function checked monthly in primary care prior to clinic review at 3 months. Carbimazole can be restarted if clinically indicated and treatment with thyroxine was recommended if their TSH was greater than 3.5 mU/l (ref range 0.35–5.5). A previous audit had demonstrated that 24% of patients had an elevated TSH great...

A 37-year-old Nigerian lady was referred to the endocrinology clinic with worsening dyspnoea, weight loss, poor sleep and palpitations over the preceding few months. She had a past history of depression treated with citalopram. She was clinically and biochemically thyrotoxic with a TSH <0.01 μ/l [0.4–5] and free T4 49.3 pmol/l [9–19]. TSH receptor antibodies were positive. She was commenced on carbimazole 40 mg once daily and propranolol 40 mg twi...

The basics of molecular genetics are reviewed with emphasis on introducing terminology frequently encountered in genetic lab results and in lectures focusing on the genetic origins of disease. Mutations thought to be associated with various phenotypical features of Turner syndrome are identified. Specific examples of genetic test results revealing Turner syndrome are reviewed. The new molecular testing available for diagnosing Turner syndrome is presented. Applications to the ...

Problem: Programs for adolescents with Turner syndrome (TS) are currently based on evidence derived from medical surveillance or parental and teacher perceptions. Little is known about how personal perceptions in this population influence behavior and psychosocial outcomes. Facing issues associated with puberty and young adulthood, such as body image, relationships, and careers, can be more challenging when living with TS.Framework: Unlike frameworks for...

The relationship between coeliac disease and primary hypothyroidism is recognised, however, a less well recognised association exists with secondary hypopituitarism as illustrated by this case.A 50 year old male was referred with a six month history of altered bowel habit, iron deficiency anaemia and presumed primary hypothyroidism (TSH 15, free T4 <5.0). He had negative investigations for any gastrointestinal blood loss. Duodenal biopsy showed non-s...

A 60-year-old Caucasian male was referred to our Endocrine unit with symptoms suggestive of adrenal failure (malaise and fatigue).A Synachten test confirmed the diagnosis (baseline cortisol <5 nmol/l, post Synachten 74 nmol/l) and indicated secondary adrenal failure (baseline ACTH undetectable). Further hormonal tests showed secondary hypothyroidism (TSH 0.43 mU/ml, FT4 7.1 pmol/l) and hypogonadism (testosterone <0.7 nmol/l, LH 0.6 U/l). Prolacti...

Background: The treatment of choice for symptomatic primary hyperparathyroidism (PHPT) is surgery, however in many cases patient choice or medical comorbidities preclude this treatment modality.Aim: This audit examines the use of cinacalcet in management of primary hyperparathyroidism in a district general hospital to determine if it is in accordance with the National institute for health and care excellence (NICE) guidance (May 2019).<p class="abste...

Screening of patients with diabetes for psychological distress should be undertaken regularly by the diabetes nurse specialist. Patients requiring intensive treatment of their diabetes experience emotional and mental health issues at a rate higher than the general population and recent clinical research shows value in cognitive and behavioral therapy. We undertook a survey of a mixed population in Dubai, United Arab Emirates to assess diabetes distress scores among our patient...

Introduction. We present a rare and unusual case of direct trauma to the pituitary region.History. A 22 year old female, 8 weeks post-partum, fell downstairs on to a metallic clothes drier. A metal spike 3mm wide and approximately 20cm long penetrated her right eyebrow. Computed tomography showed a haemorrhagic track involving the hypothalamic region, and extending to the left internal capsule. Irritability and instability of vital signs necessitated in...

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