Endocrine Abstracts

Background and objectives: Ineffective communication is one of the leading causes of medical errors and patient dissatisfaction. We implemented an initiative for dynamic endocrine tests to enhance communication with primary care colleagues and patients.Methods: We introduced a comprehensive system of organising dynamic tests, structured documentation, weekly endocrine meeting to discuss the results and standardised escalation process for suspected abnorm...

Introduction: Adrenocortical carcinomas are rare aggressive tumors. 36 % of patients with ACC have distant metastasis on presentation. Although lung metastasis are commonly seen in metastatic Adrenocortical carcinoma, cannonball pulmonary metastasis which are solid and well circumscribed parenchymal masses of variable size are rare and typically seen in Renal cell carcinoma and also in other cancers such as bone sarcomas. We report a case of functional Adrenocortical cancer wi...

A 29-year-old pregnant lady known hypothyroid for 5 years, presented with thyroid eye disease (TED). She is a non-smoker. Her TFT in the past years has been stable.Her exophthalmos was noticed at early pregnancy. Her anti-thyroid peroxidise antibodies (TPO-Ab) were >1300 mU/l (ref. range <1.4) and TSH-R antibodies (TRAB) were 18.6 U/l (ref. range <5.0).On presentation she was clinically and biochemically euthyroid with ...

Aim: To present a case of a 54 year old gentleman presenting with polyuria and diagnosed with cranial diabetes insipidus.Methods: The case history, including, detailed results of laboratory tests are presented, and the findings are discussed.Results: Way back in October 2004 Mr Z.A. was referred to the ENT surgeons with hearing difficulties in the right ear. He was diagnosed with catarrhal otitis media and chronic rhinitis. Symptom...

ACTH insensitivity syndromes comprise a rare, and underrecognised, group of disorders, which include familial glucocorticoid deficiency (FGD) and triple A or Allgrove syndrome (ACTH insensitivity, alacrima, achalasia and neurological involvement). They are characterised by undetectable cortisol and very high circulating ACTH with resultant hyperpigmentation and are inherited in an autosomal recessive manner. Distinction between FGD and triple A syndrome may be difficult and is...

Pregnancy and lactation-associated osteoporosis (PAO) is a rare syndrome of spontaneous fragility fractures, most commonly vertebral, occurring in late pregnancy or lactation. The aetiology and pathogenesis of this osteoporosis are unknown, and early diagnosis and management are essential because of the severity of the morbidity associated with these fractures. The management includes cessation of breastfeeding, use of specific osteoporosis drugs, and adequate analgesia.<p...

Case history: A 26-year-old female presented with acute left-sided loin pain. There was a preceding dull ache for two months. She had no dysuria or haematuria. Her past medical history was unremarkable except for rhinosinusitis. Investigations: Abdominal CT revealed oval shaped lesion adjacent to the upper pole of the left kidney. The left adrenal gland could not be separately visualized. The lesion had mass effect on the fundus of the stomach. Adrenal M...

Incidental adrenal masses is a common finding on abdominal imaging completed for other reasons. Majority of these masses are benign non-functioning adenomas. Investigations are required to ensure they are benign and do not have autonomous hormonal secretion.Aim: We completed an audit to review current practice in the assessment of adrenal incidentaloma at our organisation, a mid-size acute DGH, and compared it with European Society of Endocrinology (ESE)...

Background: The treatment of choice for primary hyperparathyroidism (PHPT) is surgical parathyroidectomy. Cinacalcet is the first calcimimetic approved by European Medicines Agency (EMA) in 2008 for use in patients with PHPT who are not fit for surgery or refuse surgery. British National Formulary (BNF) recommends it for hypercalcaemia in PHPT where parathyroidectomy is inappropriate. The main aim of treatment with cinacalcet is to keep calcium levels at safe levels.<p cla...

Introduction: Isolated vomiting is a rare often forgotten presentation of Graves’s disease and can lead to delayed diagnosis. Multiple case reports quote vomiting in thyrotoxicosis co-presenting with Addisonian crisis, diabetic ketoacidosis or with abnormal liver function and jaundice. Another common association is hyperemesis gravidarum. Vomiting in paraneoplastic hyperthyroidism occurs through a similar mechanism of beta-HCG secretion, mainly related to germ-line tumour...