Endocrine Abstracts

Case history: A 70 year old man presented with a six month history of sore throat and dysphagia. His past medical history included Type 2 diabetes and dysarthria due to tracheomalacia following tracheostomy at the age of 40 when he was involved in a road traffic collision. Initially he was diagnosed with gastroesophageal reflux, but symptoms did not settle with proton pump inhibitor medication. He as therefore referred to the ENT team for further evaluation.<p class="abste...

Maternal thyroid hormones play a critical role in foetal brain development in the first 12 weeks of gestation. Children born to hypothyroid mothers, especially those undertreated, are more likely to suffer lower IQ. Based on BES guidance 2007 and NICE 2011 at confirmation of pregnancy a woman with hypothyroidism should immediately increase the dose of levothyroxine by 25–50 mcg with aim TSH of less than 2.5 mu/l as soon as possible with monitoring of TFT every 4 weeks.</p...

Background: Evidence shows relative adrenal insufficiency is one of the complications known to be associated with major procedures such as cardiopulmonary bypass surgery or critical illness. This is the first case we are presenting someone with acute hypoadrenalism following post thrombin injection to treat pheudoaneurysms.Case: We present an interesting case of 55 years old man with known decompensated alcoholic liver disease with oesophageal varices, p...

Introduction: Hyponatremia is a common electrolyte disorder in clinical practice. We did a retrospective analysis of 100 patients admitted between Jan 2019 to June 2019 with moderate hyponatremia (Na-125-129 mmol/l) to see if there was a difference in management and outcome of the patients who were formally coded as hyponatremia and those who were not coded as such.Results: Mean age was 74 years in the coded group (n...

A 32-years-old lady was admitted with raised calcium. She had palpitation, sweating, 3 stones weight loss and neck swelling. She was diagnosed with Graves’ disease 5 months ago. Her mother had history of thyroid disease but no family history of hypercalcaemia. She had a small goitre and lid lag on examination. On admission, adjusted calcium was 3.04 mmol/l. PTH was < 0.5 pmol/l. Phosphate, vitamin-D, kidney functions, cortisol, myeloma screen and ACE levels ...

Introduction: Growth hormone secretogogues (GHS) are popular among body building communities as muscle bulking agents. We present an interesting case of new onset diabetes induced by a combination of GHS and selective androgen receptor modulators (SARMs).Case report: A 34-years body builder was referred by his GP due to a 3-week history of polyuria, polydipsia and fatigue. He had recently used one cycle of a combination tablet which contained Ibutamoren ...

Background: Hyperprolactinaemia is a common presentation in endocrine clinics. Current guidelines on BMJ best practice recommend evaluation with MRI only if levels are >2000 mU/l or absence of an identifiable secondary cause.Aim: To identify if pituitary pathology would go undetected if pituitary imaging is not performed and determine a suitable threshold for performing pituitary imaging in the diagnosis of prolactinoma.Methods: A ...

Background: Severe maternal hypothyroidism during pregnancy may be associated with delayed development and lower IQ in the foetus. BES (2007) and NICE (2011) guidelines recommend maintaining TSH<2.5 mU/l with monitoring of maternal thyroid function test (TFT) 4 weekly, especially in the first trimester.Aim and methods: A retrospective study on all pregnant women with established hypothyroidism attending the Joint Antenatal Clinic (JANC) at Liverpool ...

Section 1: Case history: A 61-year-old lady was referred by her GP to our endocrine clinic with abnormal thyroid function tests (TFTs) incidentally identified in routine blood tests. She had no symptoms suggestive of thyrotoxicosis apart from occasional palpitations when using inhalers for asthma. She had no family history of endocrine significance. She was on salbutamol, salmeterol, fluticasone inhalers and laxatives. Physical examination was unremarkable with no goitre. ...

Case history: A 25 year old primigravid woman was referred through to the Joint Antenatal clinic with a 15-year history of Diabetes Mellitus Type 2 treated with metformin. Her past medical history included polycystic ovarian syndrome, (causing significant hirsutism and amenorrhoea), non-alcoholic fatty liver disease, dyslipidaemia and hypertension (previously investigated for secondary causes). Her HbA1c was well controlled at 30 mmol/mol, and her Metformin had been discontinu...