Endocrine Abstracts

Hypercalcaemia due to primary hyperparathyroidism during pregnancy may be associated with maternal and foetal complications as well as neonatal tetany. Asymptomatic women with mild hypercalcaemia may be managed conservatively. Symptomatic patients or those with severe hypercalcaemia should be offered parathyroidectomy in the second trimester. This session will summarise the current practice in the management of patients with hypercalcaemia during pregnancy at Hammersmith Hospi...

Hypercalcaemia due to primary hyperparathyroidism during pregnancy may be associated with maternal and foetal complications as well as neonatal tetany. Asymptomatic women with mild hypercalcaemia may be managed conservatively. Symptomatic patients or those with severe hypercalcaemia should be offered parathyroidectomy in the second trimester. This session will summarise the current practice in the management of patients with hypercalcaemia during pregnancy at Hammersmith Hospi...

All patients with phaeochromocytoma should undergo surgical resection by an experienced surgeon. Surgery should only be carried out after adequate medical preparation to minimize catecholamine-related adverse events. Pre-operative pharmacologic treatment is aimed at controlling hypertension and tachycardia, and volume expansion. This session will summarise the current practice in the medical management of patients with phaeochromocytoma at Hammersmith Hospital....

Patients with acromegaly have characteristic clinical features of soft tissue overgrowth. Both somatic and metabolic features of acromegaly are secondary to excess GH secretion and high circulating levels of insulin-like growth factor 1 (IGF1). However, an acromegaloid phenotype associated with severe insulin resistance is occasionally seen in the absence of biochemical hallmarks of acromegaly (insulin-mediated pseudoacromegaly). Here we present a case of ‘insulin-mediate...

Background: Studies suggest that glucocorticoid hypersecretion alongside primary hyperaldosteronism (PA) is common and may contribute to the adverse metabolic phenotype. Adrenal crisis post-surgery for PA is rare.Aim: To determine the prevalence of cortisol co-secretion in PA in patients at Imperial College London NHS Trust, Hammersmith Hospital (a tertiary referral centre for adrenal tumours).Methods: Am...

Background: Studies suggest that glucocorticoid hypersecretion alongside primary hyperaldosteronism (PA) is common and may contribute to the adverse metabolic phenotype. Adrenal crisis post-surgery for PA is rare.Aim: To determine the prevalence of cortisol co-secretion in PA in patients at Imperial College London NHS Trust, Hammersmith Hospital (a tertiary referral centre for adrenal tumours).Methods: Am...

Case history: 36 years old, 14 weeks pregnant lady was referred to endocrinology department by GP urgently with corrected Calcium CCa of 2.97 mmol/l and normal parathyroid hormone (PTH). Her symptoms were urinary frequency and nausea. She had 3 previous miscarriages and 2 normal births. She was on folic acid and vitamin D supplements. There was family history of type 2 diabetes and B12 deficiency. Her 6 family members had normal calcium levels.Investigat...

Case history: We report a 56-year-old man who was referred to the Endocrinology Clinic with hypokalaemic hypertension. He had a history of bladder cancer 9-years previously, treated with surgery, chemotherapy and BCG therapy. At referral, he was taking Amlodipine 10 mg and Doxazosin 8 mg twice daily with average home blood pressure readings of 160/90 mmHg.Investigations: Aldosterone to renin ratio (ARR), taken on Doxazosin with potassium 3.6 mmol/l was 3...

Introduction: Graves’ disease is the commonest cause of hyperthyroidism accounting for 80% of all cases. The first line treatment for Graves’ disease in the UK is medical therapy, most frequently using a ‘dose-titration’ regimen. Currently, there is a lack of guidance to aid clinicians in carrying out optimal dose-titration of carbimazole, resulting in a risk of under- or over-treatment. Thus, we aimed to develop a carbimazole dosing-algorithm for the medic...

Introduction: Diaphoresis, or excessive sweating, is well recognised as a presenting complaint for endocrine disorders such as hyperthyroidism, acromegaly, and phaeochromocytoma. However, diaphoresis is an unusual presenting complaint for Cushing’s syndrome.Case: We present the case of a 35-year-old lady who first presented to health services for symptoms of excessive sweating, and feeling hot most of the time. Whilst initial investigations such as ...