Endocrine Abstracts

The association between thyrotoxicosis and osteoporosis has been recognised for over 100 years. Clinical studies in hyperthyroidism reveal a state of high bone turnover with activation of both osteoclasts and osteoblasts.A longitudinal clinical study was performed in patients with thyrotoxicosis to study changes in serum and urinary biochemical markers of bone turnover and in bone mineral density. Bone density increased by 6% following 1 year of treatmen...

Aim: To review the local clinical practice of use of third agent in the treatment of type 2 diabetes and comparison of clinical efficacy of available third agents and patient motivation with these agents. Method: We used the computerized records of type 2 diabetic patients who were started on third pharmacological agent (tablets, insulin, exenatide or liraglutide) or GLP-1 agonists which may not be the third agent and followed them up for 6 months. Medical notes were used if a...

Case history: A 30-year-old Afrocaribbean lady with a history of Graves’ thyrotoxicosis (2012) and subsequent thyroidectomy (2013) presented to the antenatal clinic in January 2020 at 9+6w gestation. Medication included levothyroxine 125 mg daily. She had a history of neonatal thyrotoxicosis in her first pregnancy in 2017 which required carbimazole therapy due to fetal tachycardia.Investigations: At booking, thyroid function tests (TFTs) showed a TS...

Introduction: Here, I present an interesting case of stuttering priapism in a 48 years old man. He was 30 years old when he was diagnosed with this condition. He is being treated with cyproterone acetate with significant improvement in his symptoms.Clinical case: A 30 years old man (now 48) presented to A&E with painful prolonged erection (priapism). He denied any history of trauma, blood disorders, use of recreational drugs, over the counter drugs o...

Introduction: I present here a challenging case of gastrinoma which posed challenges in diagnosis and treatment. Gastrinomas are tumours of pancreas or duodenum secreting excessive gastrin leading to acid over secretion in stomach leading to ulcer, perforations, and diarrhoea.Clinical case: A 77-year-old lady had been suffering from gradually worsening bouts of severe watery diarrhoea and vomiting for previous 10 years and six stones weight loss. Frequen...

Background: I present a young girl with maturity onset diabetes of young type 5 (MODY 5) who presented with renal cysts and early onset bilateral cataracts with gradual decline of beta cell functions.Case: 19 years old girl presented to A&E with hyperglycemia, ketosis, and acidosis. This was her second presentation in A&E in previous 3 weeks. She was diagnosed with type 1 diabetes when she was 3 years old in view of her polyuria and slow growth. ...

Introduction: I present here a patient with congenital adrenal hyperplasia and Fragile X syndrome. The two conditions are rare and not known to be related to each other.Clinical case: A 26-years-old lady was referred to Endocirne clinic with primary amenorrhoea. She complained of hirsutism and some facial acne since 14 years of age. To the best of her recollection her thelarche was around 12 years of age and pubic hair started to appear at 10 years of ag...

Case history: A 29-year-old man presented with infertility. He also complained of difficulty in passing urine. He also complained of low libido and ejaculate was also noted to be watery. He complained of occasional difficulty in maintaining erections. He denied history of trauma, radiation exposure or use of illicit drugs. He had normal pubertal development and secondary sexual features. He had undergone a surgery about 11 years ago in Nigeria for hypospadias. Hypospadias was ...

Obesity is almost invariably present in Cushing, but is of little diagnostic value because of its high incidence in the population as a whole , particularly in women between the age of 20 and 50 years who are the most likely to be suffering from Cushing’s Syndrome. Clinical acumen, however, is insufficient to establish the diagnosis, and confirmation depends on showing that cortisol production is in excess of normal. Because obesity is increasing at an alarming rate throu...

The amount of radioactivity given to patients undergoing ablation for remnant tissue in thyroid cancer at our centre has been greatly reduced to 1100 MBq I-131 in recent years, prompting a review of practice. An extensive risk assessment, focusing particularly on radiation exposure to the public during the patient’s commute home was conducted and found patients could now be discharged safely on the day of treatment. Owing to these findings and audit showing 86% of patient...