Endocrine Abstracts

Case history: A 73-year-old gentleman was admitted for evaluation of recurrent hypoglycaemia. He has had type 1 diabetes mellitus for 60 years, which was well controlled on a basal-bolus regime with carbohydrate counting. He had frequent hypoglycaemic episodes for 5 months despite drastic reduction in insulin dosage. His insulin was completely stopped on admission. He did not develop ketosis and continued to have hypoglycaemia. He did not have end-organ complications from T1DM...

Background: Polycystic ovary syndrome (PCOS) is believed to be a primeval condition with the earliest hints of its existence found in ancient Egyptian literature. Despite its negative impact on fertility, it has emerged as the most common endocrine disorder in women of reproductive age, creating what is called the PCOS paradox. We hypothesized that this phenomenon can be explained by testosterone-mediated high bone mineral density (BMD) in women with PCOS, providing a survival...

Hypopituitarism is associated with increased cardiovascular mortality. It has been suggested that hypogonadism, hypothyroidism, growth hormone deficiency (GHD), or indeed unphysiological hormone replacement regimens, might contribute to this excess cardiovascular risk. The adverse effect of hypercortisolaemia on insulin resistance, carbohydrate metabolism and hypertension is well recognised. It is also known that glucocorticoids adversely affect the coagulation-fibrinolytic sy...

A 15-year-old boy presented with a spiral fracture of left tibia and fibula in 1980. Adjusted serum calcium was 3.38 mmol/l. He had biochemical primary hyperparathyroidism and a superior parathyroid adenoma was removed. His calcium normalised and he was well for next 13 years until 1993 when his calcium began to rise with multiple palpable cervical lymph nodes. He underwent extensive neck dissection. Lymph node histology showed metastases from poorly differentiated parathyroid...

: In patients with subclinical hypothyroidism, soy protein and isoflavone combination has been shown to increase the risk of developing overt hypothyroidism; however, it is unclear if soy affects thyroid function in those without existing thyroid compromise.Materials and methods: Two double blind randomised trials were undertaken in which thyroid function was performed routinely at the beginning and end as a secondary end point. In both trials soy protei...

Background: The use of radioactive iodine treatment (RAI) for the definitive treatment of benign hyperthyroid disorders has been well established. This study was conducted to determine the factors predicting the development of hypothyroidism following RAI therapy.Methods: All patients (n=104, 25 men, 79 women) who had RAI for hyperthyroidism between January 2008 and December 2009 were included. In 82.6% of patients antithyroid medications were u...

Introduction: Normocalcemic hyperparathyroidism is a less recognised variation of primary hyperparathyroidism (pHPT). Patients present with normal calcium and elevated level of PTH.Case: A 70 years old woman presented to her general practitioner with left sided loin pain. She had no past medical history of note and she was not taking any medications. Ultrasound of the urinary tract showed bilateral nephrocalcinosis. Her blood tests showed raised PTH leve...

Background: Vitamin D insufficiency is very common in general population and in patients with primary hyperparathyroidism (PHPT). Measurement of serum 25OHD (25hydroxy-vitamin D) is currently the best available test to assess vitamin D adequacy. However, it has a significant seasonal variation, and is difficult to define a serum 25OHD level that is sufficient for bone health, although a serum 25OHD above 50 nmol/l has been suggested.Previous studies conf...

Introduction: With increased biochemical screening primary hyperparathyroidism (pHPT) is discovered incidentally while patients are still asymptomatic.Objective: To assess the impact of surgery on neuropsychological symptoms in people with apparent asymptomatic pHPT.Methods: Twenty-four patients with asymptomatic pHPT requiring parathyroidectomy, in accordance with NIH recommendations, were recruited prospectively between May 2005 ...

Aims and objective: Pegylated interferon is widely used in the treatment of hepatitis C. Thyroid dysfunction (TD) is a well recognised side effect of interferon treatment. As the use of interferon therapy in hepatitis C is on the rise, we conducted an audit to determine its prevalence and to formulate local guidelines for the monitoring and management of thyroid dysfunction in these patients.Methods: A case note based retrospective audit of all patients ...