Endocrine Abstracts

A 27 year old, Caucasian female was admitted with vomiting and found to have severe hypocalcaemia. On clinical examination she had a normal stature, oval face; she was not brachydactylic and did not have dental hypoplasia. Biochemically she had serum Ca of 1.49 mmol/l (2.15–2.50), a high serum Phosphate of 1.50 mmol/l (0.9–1.45) and Vitamin D levels of 59 nmol/l (>50 sufficient for majority population). Her serum parathyroid hormone was elevated at 304.5 ng/l (15...

In 2022, a 63 year old woman was referred for assessment of a six month history of gastro-oesophageal reflux symptoms and dysphagia. Upper gastrointestinal (GI) endoscopy was normal apart from mild reflux oesophagitis. A computerized tomography (CT) scan demonstrated a 2 cm nodule medial to the caudate lobe of the liver, a 1.5 cm nodule in the right lung base and two further sub cm nodules in the right lung lobe. In terms of background, the patient had a benign breast lump und...

A 31-year-old man originally from Ukraine attended the clinic having been started on Carbimazole 20 mg by his GP. His symptoms included intermittent palpitations, sweating and poor sleep and they had improved since starting anti-thyroid therapy. He was originally diagnosed with thyrotoxicosis in Germany in 1999 but was not treated and he re-presented in 2005. This time he was started on Carbimazole but stopped treatment on his own accord after a month because his symptoms impr...

A 60 year old lady was diagnosed with thyrotoxicosis in 1985 (aged 28) five months postpartum. She underwent partial thyroidectomy in 1990 (age 32). Thyroid tests remained abnormal and in 1992, she underwent radio-iodine treatment requiring post-treatment. She remained under endocrine supervision and the TSH was found to be persistently elevated with normal free thyroid hormone levels (whilst on Levothyroxine). Issue with compliance and assay interference were considered. She ...

Objective: Based on recommendations from the Clinical Practice Guidelines committee group on management of adrenal incidentalomas our project aims to review whether patients found to have adrenal incidentalomas were managed as per recommendations of the committee as follows: If they had a 1 mg overnight dexamethasone suppression test,were they tested for phaeochromocytoma, whether the investigations were used judiciously keeping in view patients co-morbid state, were any of th...

A 71 year old gentleman, known to have Renal Cell Carcinoma with metastasis to lung, mediastinum, spine and liver, was transferred to our services for management of T2/T3 Spinal root impingement. On admission he was noted to have severe hypercalcemia of 3.33mmol/l, mild hypophosphatemia 0.8mmol/land an ongoing acute kidney injury. He had appropriate initial management with intravenous fluids, and was started on dexamethasone 8 mg with PPI cover for the spinal metastasis. His i...

Introduction: The hyperparathyroidism-jaw tumour syndrome is a rare autosomal, dominantly inherited disorder characterized by neoplastic or cystic lesions in parathyroid gland, jaws and the kidneys. With approximately 200 reported cases in literature this condition remains a challenge both diagnostically and in guiding further management.Case report: Seventeen year old scholar was seen by the maxillofacial department at Medway Hospital with 2 painless sw...

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...

A 19 year old Bangladeshi male attended ED with a fractured finger. He was noted to have a severely delayed bone age of 13.5 years, and no facial hair. He had moved to the UK aged 11 and could recall little information regarding his childhood or his parents. He had no significant medical co-morbidities, and in particular no history of mumps, measles or testicular injury. He reported being the shortest in his class, and being unable to keep up with his classmates in physical ac...

Background: Tertiary adrenal insufficiency (TAI) is a complication of long-term exogenous steroid use which results in suppression of the hypothalamic-pituitary-adrenal (HPA) axis. The short synacthen test (SST) is used to assess HPA axis function and recovery during glucocorticoid weaning. This study examined the effect of steroid preparation, dosage and therapy duration on HPA axis suppression.Method: A retrospective analysis of 950 SSTs performed betw...