Endocrine Abstracts

66 year old man who had hypertension treated with Amlodipine 5 mg, Perindopril 10 mg, Nebivolol 5 mg, Doxazosin 8 mg and a Thiazide diuretic from the age of 45 with previous history of subarachnoid haemorrhage and DVT presented to emergency department with episode of weakness, nausea and dizziness. His serum potassium at initial presentation was 2.3 mmol/l. After stopping thiazide diuretic and beta blocker for 4 weeks and being commenced on Amlodipine 5 mg, Doxazosin XL 12 mg ...

The Insulin tolerance test (ITT) is regarded as the gold-standard for diagnosing ACTH deficiency but some normal subjects do not exhibit an adequate cortisol response to hypoglycaemia. Identification of false fail cases in pituitary patients is important so as to avoid unnecessary treatment with glucocorticoids. Two hundred consecutive ITTs in pituitary patients were analysed. Twenty six (13 males) failed the ITT and subsequently have a Short Synacthen test (SST). 20 patients ...

Introduction and aim: Primary hyperparathyroidism is the commonest cause of hypercalcaemia in out patient population. Primary hyperparathyroidism has become relatively common over the recent years as calcium levels are routinely evaluated since the introduction of multichannel analysers worldwide. Our aim was to audit the use and role of preoperative imaging (Ultrasound and Sestamibi scan) in localising parathyroid adenoma.Methods: We reviewed case notes...

A 34 year old male diagnosed with congenital adrenal hyperplasia (21 hydroxylase deficiency, salt wasting variety) shortly after birth. Initial presentation was poor feeding with hypoglycemia, pigmented scrotum with elevated 17-OH progesterone. He had a right orchidopexy at age 9 for undescended testis. He was admitted multiple times with adrenal crises during his childhood. He went through puberty and achieved height of 177 cm which is 75th centile. His sister also has CAH. H...

Medicago sativa plants are commonly used as green fodder. In this study, estrogen-like activity of ethanolic extract of Medicago sativa plants and its possible effects on serum biochemical metabolites in immature female rats were investigated. Crude extract of dried Medicago sativa plants was prepared in 90% ethanol using Soxhlet’s apparatus. Fifteen immature female rats were divided into 3 equal groups. Rats of groups A and B were given the extract at the dose of 250 (lo...

A 24 yr old man complaining of visual disturbances for 7 weeks presented with acute severe headache and bitemporal visual field defects. A high density lesion in the pituitary fossa suggestive of pituitary apoplexy was initially observed on a CT scan but an MRI of the pituitary revealed an irregular structure in the suprasellar cistern and the differential diagnoses of a pituitary adenoma or an aneurysm were proposed. Routine haematological and biochemical investigations were ...

: A 26 year old 22 weeks pregnant woman was referred to the Endocrine team after she presented with high blood pressure without evidence of proteinuria. She had no past medical history and was newly diagnosed with gestational diabetes. On clinical examination, she had some clinical features consistent with hypercortisolism such as very prominent large purplish striae over her abdomen, bad facial acne, multiple superficial ecchymoses due to easy skin bruisability and excessive ...

A 47-year-old female presented to the Emergency department following an episode of loss of consciousness at home that her daughter had identified as due to hypoglycaemia (using her husband’s capillary blood glucose meter 1.1mmol/l) and treated. She reported several episodes of fainting, sweating and generalised weakness over 6 months which improved after eating snacks. There was no previous history of diabetes; she had been diagnosed with Graves’ disease 6 months pre...

Introduction: Most (89%) UK units offer some form of free patient choice for new paediatric patients commencing GH therapy. Initial data indicates that patient choice improves adherence, resulting in improved growth (height velocity) short-term.Objective: To compare outcome measures between patients offered free choice and/or hospital supply (including home services and adherence tracking assessed using ampoule counting) with GH therapy with those who di...

Background: Testosterone replacement therapy (TRT) is widely used for the treatment of symptomatic hypogonadism in men. However, data on prescription behaviours of TRT are limited. The objective of this study was to investigate clinical characteristics associated with the likelihood of being prescribed TRT by general practitioners (GPs) in North West London (NWL).Methods: We carried out a retrospective cohort study using Discover database of GP-registere...