Endocrine Abstracts

A 46-year-old lady was referred to endocrinology with thyrotoxicosis. She was diagnosed with Graves’ disease by her GP in October 2016 when presenting with classical symptoms and investigations [TSH<0.01 mIU/L (NR 0.3–4.2), fT4=34.3 pmol/L (NR 9–23), TSHrAb>30 u/mL (NR<0.4), and increased iodine uptake]. She was therefore started on carbimazole 15 mg/day. She returned to her GP in December 2016 reporting resolved symptoms, however, she ...

A 46-year-old lady was referred to endocrinology with thyrotoxicosis. She was diagnosed with Graves’ disease by her GP in October 2016 when presenting with classical symptoms and investigations [TSH<0.01 mIU/L (NR 0.3–4.2), fT4=34.3 pmol/L (NR 9–23), TSHrAb>30 u/mL (NR<0.4), and increased iodine uptake]. She was therefore started on carbimazole 15 mg/day. She returned to her GP in December 2016 reporting resolved symptoms, however, she ...

A 77 year old man with a background of Crohns disease requiring ileostomy, pernicious anaemia and hypertension, presented with a 4month history of dysphagia to solids, hoarseness of voice, anorexia and marked weight loss of 30 kg. He was initially referred to gastroenterology, who performed an endoscopy which was normal. Subsequently he was referred to the ENT and speech and language therapy departments. A video fluoroscopy confirmed severe oropharyngeal dysphagia with effortf...

A 27 year old lady with a background of Langerhans cell histiocytosis (LCH) presented to endocrinology clinic for investigation of thyrotoxicosis. At the age of three years old, she presented with a rash on her forehead, which on biopsy revealed Langerhans cell histiocytosis. She was also noted to have symptoms consistent with diabetes insipidus, for which she remains on desmopressin therapy. At the age of six she received pituitary radiotherapy and 6 years ago developed secon...

A 60year old gentleman was referred to endocrine team with new onset hyperthyroidism. He had developed tubulointerstitial nephritis secondary to carbamazepine resulting in ESRF 3 years previously. Four months prior to presentation he received a live-unrelated renal transplant including a single dose of Alemtuzamab post-operatively for induction of immunosuppression. Thereafter his immunosuppression was maintained with tacrolimus. Other medical history included bipolar disorder...

A 31-year-old engineer presented with a 6-week history of tremor, weight loss, mild goitre and palpitations. At the onset of these symptoms, he also presented to a specialist eye hospital for difficulty with focussing his vision. He had no past medical history and was taking no medications. He did not have any family history of ocular or autoimmune conditions and was a non-smoker. On examination his BMI was 20, he had very mild proptosis, no diplopia and a diffuse symmetrical ...

A 47-year-old afrocaribbean lady was referred to endocrinology clinic with a 1-month history of weight loss, heat intolerance, palpitations, fatigue and hair loss. She reported symptoms consistent with proximal myopathy including myalgia and difficulty rising from chairs. Interestingly she noted a 1-month history of hypersalivation, which had caused her significant distress in her social and work life. The hypersalivation had resulted in a change in her voice and had also inte...

Case report: A 40-year-old lady was diagnosed with acromegaly in 1993 after presentation with clinical symptoms. Imaging showed a 1 cm pituitary lesion and she underwent transphenoidal hypophysectomy in 1993. Post-operatively she was rendered hypopituitary, but still had biochemical evidence of active acromegaly. She proceeded to external beam radiotherapy and was started on bromocriptine medical therapy.On routine review in 2006, her acromegaly was bioc...

A 68-year-old woman presented with a several month history of nausea, confusion and generalised weakness. In addition, she reported decreased appetite with significant weight loss. She did not report any convulsions, abdominal pain, palpitations, or diarrhoea. Significant past medical history included well-controlled T2DM, hypertension, vitamin D deficiency and GI reflux disease. Importantly, she had no history of renal disease. Relevant medications incl...

We present a case of a 56 year-old man diagnosed with systemic mastocytosis by the dermatologists on presentation with classical skin lesions, confirmatory bone marrow biopsy and a tryptase level 105 ug/L (NR 2-14). Further genetic testing confirmed KIT D816V mutation. DEXA bone densitometry at diagnosis revealed marked osteoporosis (Lumbar T score -3.7 (Z -3.5), Femoral Neck T score of -2.0 (Z -1.1). He had no history of low trauma fracture and no relev...