Endocrine Abstracts

Authors agree that although mortality for COVID 19 is low, comorbidities may contribute to severe disease and mortality. Chinese center for disease control and prevention reported three times higher mortality in patients with diabetes. However, most studies do not take into account age of patients. Our study aimed to evaluate association of COVID in patients lesser than 65 years of age in two countries, India and United Kingdom with diabetes. We excluded patients with co-morbi...

The goals of treatment for a prolactinoma are to normalise serum prolactin and decrease the size of the tumour. Dopamine agonists (cabergoline is first-line) represent primary therapy for almost all prolactinomas. Some prolactinomas exhibit resistance to dopamine agonist treatment and require higher doses. Our patient was a 35-year-old male who presented to Ophthalmology in March 2021 with visual disturbance, confirmed to be secondary to a bitemporal hemianopia. OCT showed bil...

We present a case series of patients admitted to our hospital with various manifestations of Cushing’s. 71 male, known type 2 diabetes, hypertension referred for adrenal incidentaloma. Cushingoid features with non suppressed ACTH. Low dose dexamethasone test (LDSST): no suppression. 4 cm pituitary microadenoma (likely co-secretory as gonadotropins elevated). Offered IPSS and pituitary surgery. Declined the same due to fears of COVID opted for medical therapy with metyrapo...

Traditional literature agrees that Diabetic Ketoacidosis is typically associated with Type 1 Diabetes Mellitus, but can be associated with stress including infections in Type 2 diabetics. The authors did a restrospective evaluation of diabetic ketoacidosis presenting to a large district hospital in London. 343 patients were admitted with diagnosis of Diabetic Ketoacidosis during the COVID peaks from January 2020 to January 2021. 57% of these were Type 1 diabetics and 43% were ...

Hyperlipidaemia services in the UK are guided by National Guidance for Lipid Management for primary and secondary prevention of cardiovascular disease. Our audit studied a total of 71 patients in primary and secondary care in the greater London area with total Cholesterol levels greater than 7.5 mmols/l. In patients admitted to hospital (n=22); 27.8% patients were ITU admissions with 56% being under surgical team for acute pancreatitis. Only 45.4% of these patients we...

Disorders of sodium metabolism in sarcoidosis are predominated by diabetes insipidus; SIADH is extremely rare, restricted to sporadic case reports. We present the case of a 68 year old South Asian female presenting with a 3 year history of chronic, mild hyponatraemia, which was asymptomatic apart from mild lightheadedness. She had a history of stable sarcoidosis that was not requiring treatment, based on lung pathology. Despite fluid restriction, serum sodium remained around 1...

Hyperprolactinemia is known to have a wide differential with multiple causes including physiological, pathological and pharmacological. Drug induced causes of hyperprolactinemia are myriad however these become significant when prolactin levels rise to proportions that lead to clinical manifestations. We present a case of a 40 years old lady who was referred to endocrinology for an irregular menstrual cycle. Initial investigations revealed a prolactin level of 5767 mIU/l (range...

Traditional literature has dictated diabetes to be a chronic irreversible disease with progression of micro and macrovascular complications. Modern medicine has now started to include bariatric surgery, starch restriction as potential interventions which could control diabetes at initial stages. Our case report is unique as it illustrates patient directed reversal of diabetes with lifestyle intervention. 77 years old gentleman was diagnosed with Type 2 diabetes at the age of 5...

Adrenal vein sampling (AVS) is used to differentiate between unilateral and bilateral subtypes of primary aldosteronism (PA). However, AVS results may be misinterpreted due to a procedural artefact resulting in low aldosterone levels at the inferior vena cava (IVC), thus making an interpretation of aldosterone to renin ratios difficult. We investigated whether this artefact was due to patients’ being supine before and during AVS, given aldosterone varies with posture, and...

A 68-year-old gentleman presented with proximal myopathy in association with severe hypokalaemia (K+ 2.3mmol/l) and metabolic alkalosis. He had recently been diagnosed with type 2 diabetes. His random cortisol was 1045nmol/l. His 24-h urinary free cortisol was 3536nmol/24 h, and midnight cortisol was 85nmol/l. On a low dose dexamethasone suppression test, his cortisol failed to suppress (cortisol 1195–983nmol/l, ACTH 275ng/l), consistent with ACTH-dependent Cushing’s...