Endocrine Abstracts

Purpose: The aim of diabetes management is to prevent the micro/macrovascular complications. We have designed a quality improvement project to monitor how we are doing in term of glycaemic control and overall management of diabetes in our out-patient facility and how can we improve the outcome further.Methods: Parameters checked (HbA1C, blood pressure, lipid profile, annual fundus examination, podiatry, urine for ACR). Retrospective study of 112 patients...

Gynaecomastia is the proliferation of the male breast glandular tissue and should be distinguished from lipomastia (weight-related fat deposition, also known as pseudogynaecomastia). The development of subareolar ductular tissue and fibrosis in gynaecomastia produces a firmer consistency compared to adipose tissue, which can be differentiated on examination. Gynaecomastia is common and can affect up to two-thirds of adult men. Typically, gynaecomastia arises from an imbalance ...

Estrogen receptors (ER) are expressed in the majority of breast cancers, are key drivers of breast cancer development and progression and hence therapies to inhibit their activities are a mainstay of treatment for breast cancer. A large proportion of patients develop resistance to these therapies, so determining the mechanisms of ER action is important for improving patient management and for identifying new therapies. In defining the mechanisms by which ER regulates gene expr...

Oestrogens promote breast cancer development and progression by binding to the oestrogen receptors. Oestrogen receptor-alpha (ER) is a transcription regulatory protein that is activated upon binding oestrogen and acts by controlling gene expression in breast cancer cells and is the target for endocrine therapies that inhibit its activity by competing with oestrogen for binding to ER (anti-oestrogens) or by inhibiting oestrogen biosynthesis (aromatase inhibitors). These therapi...

A 65-year-old lady who was known to hypothyroidism and was treated with Levothyroxine 100microgram once daily for more than 20 years presented to the endocrine clinic with symptoms and signs of thyrotoxicosis. Apart from Levothyroxine, she was taking over-the-counter multivitamins and Vitamin D. Visual fields were full to confrontation and there was no goitre. Thyrotoxicosis was confirmed biochemically and levothyroxine was stopped. Despite being off Levothyroxine for more tha...

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...

Background: Pheochromocytoma is a rare tumour that arise from chromaffin cells in the adrenal medulla and produces signs and symptoms due to excessive catecholamine secretion from tumour. Presenting symptoms can vary but often they classically present with headaches, sweating and palpitations in the setting of paroxysmal hypertension. Pheochromocytoma crisis results from the sudden release of large quantities of catecholamines and leads to progressive multiple organ dysfunctio...

A case of a 48-year-old lady who is under follow-up in the clinic at Causeway Hospital, Northern Ireland for hyperthyroidism. She has a medical history of SLE under follow-up Rheumatologists and bronchial asthma. She presented with palpitations, tremors, sweating, and heat intolerance. On examination, the patient appears anxious. Blood pressure was 130/80, PR 140, RR 20, T 37, SPO2 98% A. Her eye examination revealed no lid lag, exophthalmos, and no redness. Examination of the...

Case: 55 year old male presented with severe sharp and burning pain at anterior aspect of both legs (radiating from groin to feet), worse at night, unable to keep bed sheets lying on legs due to pain (allodynia). Patient reported weight loss of 3 stones in last 1 year including a recent 1 stone weight loss in 2 months. Patient is a type II DM for the last 3 years. He was intolerant to Metformin and is on Gliclazide 160 mg BD. Alcohol intake around 40 units per week. Initial in...

A 34-year old pregnant lady had induction of labour with prostaglandins and oxytocin infusion after her due date. She failed to progress in labour and became slightly disoriented. Urgent biochemistry revealed serum sodium of 124 mmol/l. She delivered a healthy baby by forceps but had post-partum haemorrhage of 1.5 l. Oxytocin infusion was continued along with Hartmann’s solution. She became drowsy and biochemistry revealed serum sodium of 118 mmol/l, low serum osmolality,...