Endocrine Abstracts

Introduction: Hypoparathyroidism is a rare endocrine disease with a prevalence of less than 40/100,000 people worldwide1. It has a variable presentation but can present with life-threatening arrhythmias or seizures.Case PresentationA 31-year-old male presented to our Emergency Department following a witnessed tonic-clonic seizure with no previous history of epilepsy. He was not on any regular medications and denied recreational drug use. Examination was largely unre...

History: A 38-year-old Afghan lady was referred for investigation of secondary amenorrhoea. She had had no menstrual periods since her first spontaneous pregnancy, except when recently taking a combined oral contraceptive pill (COCP). When living abroad, she conceived on three further occasions with clomiphene induction, resulting in two live births and one miscarriage. In addition, it was noted that she had never been able to breast-feed any of her children. She did not have ...

Background: Short Synacthen tests (SST) are both inconvenient and expensive, especially since the cost of tetracosactide recently increased 15-fold to over £45/ampule. A retrospective review was performed to see whether the number of SST’s could be reduced in our institution.Methods: All 76 adult inpatient (mean age 67) and 106 adult outpatient SST’s (mean age 50) from a 12-month period were reviewed for indication and whether a preceding ...

Background: Short Synacthen tests (SST) are inconvenient and expensive, especially since the cost of tetracosactide recently increased to over £45/ampule. Historic literature on the minimum 9 am cortisol required to avoid a SST ranges from 243 to 500 nmol/l and individual endocrinologist practice varies greatly.Methods: In an audit of all 182 SST’s from 1 year at our institution, either a previous 0900 h cortisol was recorded or the basal corti...

Background: Spontaneous coronary artery dissection (SCAD) is a rare condition, which is sometimes underdiagnosed in patients with chest pain and presumably normal coronaries. There have been a few case reports of patients with thyroid dysfunction and arterial dissections.Case: We present a 20 year old female with recent diagnosis of Graves’ thyrotoxicosis managed with methimazole. She initially presented in South Korea with shortness of breath on ex...

Case history: A 64-year-old male was admitted to our hospital in January 2024 following a road traffic accident. The patient was not wearing a seatbelt, and airbags did not deploy due to low speed, resulting in the patient’s head hitting the windscreen. A subsequent CT trauma series showed a large destructive expansile lesion within the clivus and sphenoid bone extending superiorly into the hypothalamus with findings typical of a chordoma. Appearance on non-contrast MRI w...

Case summary: A 55 year-old lady was referred by ophthalmology following diagnosis of bilateral central serous retinopathy, an accumulation of sub-retinal fluid at the fundus associated with Cushing’s syndrome. She also had proximal myopathy, bruising, centripetal weight gain and hypertension. Cushing’s was confirmed by 1 mg overnight DST (cortisol 581 nmol/L) and 48 hr-LDDST (407 nmol/L). 24 hr UFC was raised at 2666 nmol/L (12...

Case summary: A 55 year-old lady was referred by ophthalmology following diagnosis of bilateral central serous retinopathy, an accumulation of sub-retinal fluid at the fundus associated with Cushing’s syndrome. She also had proximal myopathy, bruising, centripetal weight gain and hypertension. Cushing’s was confirmed by 1 mg overnight DST (cortisol 581 nmol/L) and 48 hr-LDDST (407 nmol/L). 24 hr UFC was raised at 2666 nmol/L (12...

Oncogenic ostemalacia is a rare paraneoplastic syndrome characterised by renal phosphate wasting secondary to secretion of FGF-23 from mesenchymal tumours. Localisation of the tumour is wanted, as resection can lead to complete clinical and biochemical cure. We present a case of a 57 year old woman with a background of Vitamin D deficiency and secondary hyperparathyroidism, who presented with severe generalised aches and pain, worst in her ribs and thighs, such that she could ...

Background: Multiple endocrine neoplasia type 2 (MEN2) is a group of pleomorphic syndromes which infer a susceptibility to several endocrine conditions. The RET Val804Met mutation is classified as a moderate-risk mutation for familial medullary thyroid cancer (MTC), without the other components of MEN2 syndromes. However, here we describe a rare case of a gentleman with RET p.V804M, presenting with primary hyperparathyroidism (PHPT) and no evidence of MTC.<p class="abstext...