Endocrine Abstracts

Introduction: We describe a patient with Fibrodysplasia ossificans progressiva (FOP) who developed an osteomyelitic neuropathic toe ulcer. This was treated effectively with conservative measures, but highlighted the need for multiprofessional working in managing patients with FOP.Case: The patient’s toe ulcer occurred in 2017 and was initially managed by community podiatry and orthopaedics. The patient received multiple courses of antibiotics for r...

Aim: In light of recent publications - could a lower cortisol cut off value of ~350 nmol/l be used to safely rule out adrenal insufficiency (AI) compared to current local guideline cutoff value of either a baseline or 9am cortisol of 420 nmol/l? If so could this potentially help reduce the number of Co-syntropin stimulation tests (CST) performed?Background: Current local guidelines recommend a cortisol cut value of 420 nmol/l to rule out adrenal insuffic...

Introduction: Water deprivation testing (WDT) is considered the gold standard test in differentiating between craniogenic diabetes insipidus (DI), nephrogenic DI and primary polydipsia. However, it requires day case admission for monitoring of sodium and osmolality. Copeptin, derived from pre-provasopressin, is secreted in an equimolar amount with arginine vasopressin and has a potential role in facilitating the diagnosis of DI and reducing the need for WDT. Copeptin was gradu...

We describe a patient who was treated for hypercalcaemia with inadvertent ramifications. A 59 year old gentleman with a background history of chronic kidney disease stage (CKD) 4, type 2 diabetes mellitus, hypertension, congestive cardiac failure and bilateral lower limb below knee amputations, presented with hypercalcemia of 3.30 mmol/l (reference range 2.20–2.60) and suppressed PTH at 12 ng/l (reference range 15–65), from a previously raised PTH level of 162 due to...

Background: Parathyroid Carcinoma (PC) is a very rare endocrine malignancy. Unlike Parathyroid Adenoma (PA) and Parathyroid Hyperplasia which represents 80% and 15-20% cases of primary hyperparathyroidism (PHPT) respectively, PC only constitutes 1-2% of cases. Herein we present a clinical case of PC following a low-impact trauma.Clinical case: A 50-year-old Bulgarian female presented with a pathological mid-shaft fracture of her right femur following a t...