Endocrine Abstracts

A 39-year-old lady with background history of autoimmune hypothyroidism diagnosed over 10 years ago, established on Levothyroxine 100 mg once daily, was referred by the GP with unusual sweating, palpitations, tiredness, anxiety, tremors and weight loss of around one stone over last few months. The thyroid function tests were suggestive of thyrotoxicosis with TSH of less than 0.05 mu/land FT4 60 pmol/l, hence the dose of levothyroxine was gradually reduced and ultimately stoppe...

A 44 years old lady with history of suspected psychogenic polydipsia (2021), presented with acute on chronic abdomen pain. She complained of lethargy, intermittent vomiting, abdomen pain, weight loss (four stones) over last six months associated with confusion and visual hallucination since two weeks. She mentioned feeling always thirsty and drinks around 4-5 litres of water per day. Her blood pressure was 87/61 mmHg, heart rate 74/min and U&Es were normal (serum sodium 14...

Young man with high BMI and known iatrogenic hypothyroidism, post radioactive iodine (RAI) treatment (2015) for Graves’ thyrotoxicosis (2011) was referred to endocrinology due to significantly raised TSH (at 50 mu/l) and low FT4 (5.0 pmol/l). He was actually admitted with progressive nausea, vomiting over last three weeks. He also complained of abnormal stool consistency (like semi-solid) intermittently. His past medical history also includes gastric bypass with gastro-je...

A male with classical salt-wasting congenital adrenal hyperplasia (CAH; 21-hydroxylase deficiency) who was diagnosed in infancy and had normal pubertal growth and development attended the endocrine department for routine follow up in June 2019 (age 26). His current daily medications are hydrocortisone 10 mg on waking, 5 mg at 4 pm and fludrocortisone 200 mg once daily. He also has injectable hydrocortisone sodium phosphate 100mg for emergency use. Over recent years, he reports...

Background: Diagnostic work-up for Cushing Syndrome (CS) can be challenging and is based on clinical and biochemical assessments. Biochemical evidence of endogenous steroid excess is demonstrated through overnight dexamethasone suppression test (ODST), low dose dexamethasone suppression test and/or 24-hour urinary free cortisol estimation (UFC). Once endogenous steroid excess is confirmed, random serum ACTH measurement is key in determining the suspected source of steroid exce...

A 41 year-old male was referred urgently from secondary care with high suspicion of Cushing’s syndrome. His past medical history included psychosis and bipolar disorder, previous low impact foot fractures, rib fractures on coughing and spinal wedge fractures on X-ray, all within the last 5 years. He was taking quetiapine 300 mg modified-release and amitriptyline 10 mg daily, and tramadol 50 mg as needed. The patient reported decreasing mobility with increasing back pain, ...

Female with primary hypogonadism have inadequate function of the ovaries, with impaired production of germ cells (eggs) and sex hormones (oestrogen and progesterone). We recently came across a 22-year old female with short stature in childhood and adulthood she received growth hormone treatment (due to arrested puberty) between 3-5 years of age and further treatment at age of 10 years. She had history of IUGR, primary amenorrhoea, sensorineural deafness, congenitally missing t...

Background: The recent Get It Right First Time (GIRT) report suggests short stay pathways should be aimed for in pituitary surgery in England, with 1–2 days being realistic. We prospectively audited the length of stay (LOS) for patients undergoing transsphenoidal surgery (TSS) for sellar and suprasellar lesions at the Royal Victoria infirmary hospital (RVI) over a 2-year period, from October 2019.Methods: Data was prospectively collected for each pa...

Introduction: Primary thyroid lymphoma (PTL) is a rare cause of malignancy, accounting for <5% of thyroid malignancies and < 2% of extra-nodal lymphomas. Most thyroid lymphomas are non-Hodgkin’s lymphomas of B-cell origin. Patients with Hashimoto’s thyroiditis are at greater risk for developing PTL. Early diagnosis is important as treatment and prognosis of PTL depend upon the histology and stage of the tumour at diagnosis. We report a rare case of primary th...

Introduction: Primary thyroid lymphoma (PTL) is a rare cause of malignancy, accounting for <5% of thyroid malignancies and < 2% of extra-nodal lymphomas. Most thyroid lymphomas are non-Hodgkin’s lymphomas of B-cell origin. Patients with Hashimoto’s thyroiditis are at greater risk for developing PTL. We report a rare case of primary thyroid lymphoma in a patient presenting with a rapidly enlarging thyroid goitre highly suspicious of anaplastic thyroid carcinom...