Endocrine Abstracts

Introduction: Trimethylaminuria or Fish Odour syndrome is a rare genetic metabolic disorder. It can cause significant suffering to affected individuals due to social isolation and stigma. It is under recognised and ignored.The case: A 60 years old lady was referred by her GP. The referral – ‘She feels she has a problem with personal hygiene and is aware of an odour from her skin, her breath and urine.’ This lady has been suffering from thi...

Diabetic ketoacidosis and pregnancy related ketoacidosis are the most common forms of ketoacidosis seen in acute medical units. We describe here two rare cases of starvation ketoacidosis.Case 1: 63 years old gentleman with no history of diabetes, presented with persistent vomiting for 48 hours. His admission bloods revealed Serum Bicarbonate of 8, pH 7.19, pCO2 2.7, base excess of -17.8, plasma glucose 5.2 mmol/l and serum alc...

Diabetic ketoacidosis and pregnancy related ketoacidosis are the most common forms of ketoacidosis seen in acute medical units. We describe here two rare cases of starvation ketoacidosis.Case 1: 63 years old gentleman with no history of diabetes, presented with persistent vomiting for 48 hours. His admission bloods revealed Serum Bicarbonate of 8, pH 7.19, pCO2 2.7, base excess of -17.8, plasma glucose 5.2 mmol/l and serum alc...

Introduction: Hashitoxicosis is the rare case of autoimmune thyroid disease. While transforming from Graves’ disease to spontaneous hypothyroid is well known, development of hyperthyroidism following hypothyroidism is a rare phenomenon which can pose a challenge in management. We report here a case of Hashitoxicosis managed with "Block and Replace Therapy" to maintain her euthyroid while waiting for definitive therapy.Case Report: A 30-year-...

We present the case of a 50-year-old lady who initially presented to the endocrine department at Royal Bolton Hospital in 2011 with symptoms of tiredness and lethargy following hysterectomy and bilateral salpingo-oophorectomy in 2003. Hormone replacement therapy was not commenced in view of a strong family history of breast cancer. There is a family history of both autoimmune hypothyroidism and hyperthyroidism. Thyroid function tests were normal, with a positive thyroid peroxi...

Introduction: Hyperthyroidism is a common endocrine disorder in pregnancy, with potentially significant foeto-maternal consequences.Description of the case: 25 year old lady with auto-immune hyperthyroidism (TRAb>400) was treated with Propranolol and Carbimazole and referred to the Endocrine clinic. She was started on Block and replace therapy. She was soon moved over to Carbimazole as she was contemplating pregnancy. She became hypothyroid in 3 mont...

Background: The Ultrasonography (USS) and Tc-SestaMiBi (MiBi) scans are established tests to localize parathyroid adenoma. It is important to utilize these appropriately prior to surgery for a positive outcome.Method: It was a retrospective study in patients diagnosed with primary hyperparathyroidism (PHPT) according to the NICE Guideline who underwent parathyroidectomy from 01/01/2015 to 31/12/2019. We aimed to assess the USS and Tc-Sestamibi scan’...

Background and aims: Statins has long been used as first line treatment option for hypercholesterolemia however; half of population doesn’t achieve target LDL reduction. Proprotein convertase subtilisin kexin 9 inhibitors (PCSK9i) are a promising addition to anti-dyslipidemic armamentarium. Aim of this study is to find out the efficacy of PCSK9 inhibitors in a district general hospital of Northwest of England.Method: We identified all the patient wh...

Pituitary infarctions are not unknown in patients with pituitary tumours. We describe here a 39-year-old lady, who presented with a history of sudden onset severe headache without any restriction of her visual fields. She had features of acromegaly with enlarged hand and feet size, progressive deepening of her voice and coarsening of facial features over the preceding year. She also had a euthyroid multinodular goitre. CT scan and MRI of the pituitary gland suggested cystic de...

Introduction: Hirsutism affects 10% of the female population caused by hyperandrogenism of benign aetiologies or androgen-secreting tumours. Tumorous causes of hyperandrogenism include androgen producing ovarian or adrenal tumours. Leydig cell tumours are rare ovarian testosterone producing tumours that comprise 0.1% of total ovarian tumours. It is rare in postmenopausal women and present with features of hyperandrogenaemia or hyperestrogenemia.Case: We ...