Endocrine Abstracts

Thyrotoxic storm is one of the rare but serious, and sometimes life threatening endocrine emergencies, the mortality rate ranges from 20 to 30%.We report the case of a 44-year-old female who had an emergency hospital admission with diarrhoea, vomiting and palpitations in September, 2011. She was diagnosed with Graves thyrotoxicosis in 2004 and was commenced on carbimazole. She was non compliant with the treatment and did not attend her hospital appointme...

The role of environmental and occupational toxins in the aetiology of unexplained infertility remains to be fully explored. Epidemiological studies have implicated heavy metals, including cadmium as having a pathogenic role with studies demonstrating associations between serum levels, testicular function and gonadotrophin levels in large cohort studies. Cadmium toxicity is associated with a complex spectrum of effects. Whilst the renal complications are well described, putativ...

Introduction: Hyponatraemia is the most frequent electrolyte disturbance in clinical practice. It is encountered in isolation or as a complication of other medical conditions. The classification of hyponatraemia by volume status and severity – mild (125–134 mmol/l), moderate (115–124 mmol/l), and severe (<115) is of significance both prognostically and as a means of guiding management.Methodology: A retrospective review was carried out...

A 59-year-old lady was admitted with lethargy and dehydration in October 1998 and investigations confirmed primary hyperparathyroidism with corrected calcium 4.49 mmol/l (N: 2.1–2.6). After fluid resuscitation, she underwent parathyroidectomy and biopsy revealed parathyroid hyperplasia. Post-operatively, her calcium remained normal until November 2000 when her corrected calcium was 3.05 mmol/l with PTH 311 ng/l (N: 12–65). Sestamibi scan failed to local...

A 69-year-old man with no family history of thyroid disease presented with weight gain and constipation. He was clinically euthyroid with no goitre. Investigations confirmed autoimmune hypothyroidism with FT4 16.9 pmol/l (N: 10–22), TSH 29.14 mIU/l (N: 0.4–4.5), elevated thyroid peroxidase (TPO) antibodies 3311 IU/ml (N: 0–34) and he was commenced on thyroxine with serial dose adjustments to 250 mcg OD over 2 years. His TSH however remained ...

Introduction: Thyrotropinomas are rare pituitary tumour accounting for 0.5–1.0% of all pituitary tumours. There are only seven reported cases of mixed TSH/LH/FSH producing adenoma. We report a patient with secondary hyperthyroidism due to TSH producing adenoma co-secreting FSH and LH.Case report: A 75-year-old Caucasian male was seen with 2-year history of tiredness, anxiety and palpitations along with 7-month history of weight loss. He also complai...

PTPN22, encodes lymphoid tyrosine phosphatise (LYP), an important inhibitor of T lymphocyte activation and has been associated with numerous autoimmune diseases including type 1 diabetes, rheumatoid arthritis, and Graves’ disease (GD). Consistent association has been reported between disease and a non-synonymous SNP +1858 C>T (rs2476601) encoding an Arginine to Tryptophan substitution at amino acid 620 of LYP. Our group was the first to show strong evidence of ...

Pituitary carcinoma is rare and diagnosis requires demonstration of cerebrospinal and/or systemic metastasis. We present case of a 64-year-old lady who presented with widespread spinal metastasis from a pituitary adenoma diagnosed 36 years ago. Our patient presented in 1971 with visual failure, headache and oligomenorrhoea. Imaging confirmed pituitary macroadenoma and she underwent transcranial hypophysectomy. Histology revealed chromophobe adenoma. Post operatively her vision...

Background: Serious complications of diabetes-related ketoacidosis (DKA) and its management with fixed rate insulin infusion (FRIII) include hypoglycaemia, hyperkalaemia and hypokalaemia. Revised Joint British Diabetes Societies for Inpatient Care (JBDS) guidelines in July 2021 recommended a reduced rate FRIII of 0.05 units/kg/hour from 0.1 units/kg/hour once blood glucose levels fall to ≤14.0 mmol/l to alleviate the risk of these complications.Aim...

Background: With increasing ethnic diversity in the Western World, it is important to establish the safety of religious practices such as fasting during Ramadan. There is limited information about severity and outcome of diabetes-related ketoacidosis (DKA) during Ramadan outside Middle East.Objective: We studied differences in severity, DKA-related complications and outcomes of DKA before (Shaban), during (Ramadan) and after Ramadan (Shawwal).<p clas...