Endocrine Abstracts

Introduction: Insulinomas are the most common functioning endocrine neoplasms of the pancreas. 53% of patients are diagnosed within five years of experiencing their first symptoms. Surgical resection is the primary treatment modality. However, patients awaiting surgery or who are not surgical candidates have achieved symptomatic relief from medical therapy. Cases of insulinoma masking diabetes has been described but are rare and diabetes often presents following surgery. Here,...

Introduction: Medullary thyroid cancer accounts only 1% to 4% of thyroid cancer cases (1). 25% of cases are familial secondary to germline RET mutation, while the remaining 75% are sporadic and also harbour a somatic RET mutation in more than half of all cases. Up to 15–20% of patients will present with distant metastatic disease. The standard treatment for MTC is total thyroidectomy and dissection of cervical lymph node compartments. Post-operative levels of serum calcit...

Introduction: Insulinomas are the most common functioning endocrine neoplasms of the pancreas. 53% of patients are diagnosed within five years of experiencing their first symptoms. Surgical resection is the primary treatment modality. However, patients awaiting surgery or who are not surgical candidates have achieved symptomatic relief from medical therapy. Cases of insulinoma masking diabetes has been described but are rare and diabetes often presents following surgery. Here,...

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 ...

Case History :A 34-year-old Caucasian female patient presented in May 2015 to A&E with symptoms of overt thyroid dysfunction. She was managed medically until June 2016 when thionamide treatment was withdrawn. Unfortunately, this lady had a first disease relapse in July 2018 whilst she was pregnant at 35 weeks of gestation and then further disease relapse in January 2020 during her second pregnancy. Investigations: Initial biochemistry in 2015 confirm...

Case history: A 49-year-old teacher presented to his GP with lethargy and lower limb weakness. He had noticed polydipsia and polyuria, and had experienced weight loss albeit with an increase in central abdominal fat mass. He had previously undergone cholecystectomy and colonic polypectomy. He took no regular medications. Investigations: He had hypercalcaemia 3.34 mmol/l with PTH of 356 ng/l and hypokalaemia 2.7 mmol/l and was admitted for intravenous flu...

Case history: A 26-year-old lady presented with a two-week history of weakness associated with pins and needles affecting the lateral calf and dorsomedial aspect of her left foot. The patient denied any trauma or symptoms including weight loss. She had no drug allergies and was taking no regular medications. She had a vegan diet supplemented with multivitamins. Her past medical and family history was unremarkable. On examination, she had a narrow-based high-steppage-gait. Lowe...

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...

Introduction: Mutations in the succinate dehydrogenase gene (SDH) predispose to the development of paraganglioma (PGL) which arise from parasympathetic and extra-adrenal sympathetic-associated chromaffin tissues. Identification of an index case results in family ‘cascade’ screening, often of asymptomatic individuals.Aims: To identify prevalence of PGL tumours and elevated plasma metanephrines at first scre...