Endocrine Abstracts

A 62-year-old lady was assessed following discovery of a retroperitoneal tumour on a CT scan. Fifteen years previously she was diagnosed with irritable bowel syndrome with alternating constipation and diarrhoea, however, within the last 5 years, diarrhoea was the dominant feature with bowel opening every 20 min daily. Investigations for inflammatory bowel disease, hyperthyroidism and coeliac disease were negative. Her anal sphincter was found to be non-functioning and a colost...

79 year old gentleman was reviewed as new patient in the Endocrine clinic. He was diagnosed with Pituitary Apoplexy of a Non-functioning Adenoma in 1998. He was under surveillance and the tumour remained relatively stable with no complications until 2008.Surgical history: There was a gradual increase in the size of the adenoma over 5 years. He underwent Transphenoidal adenectomy in Feb 2014 as the tumour was draped over the optic chiasm. Intra-operativel...

Audit was performed to identify outcomes of patients from our department referred for RAI for thyrotoxicosis over 14 month period. Follow-up data of atleast 6 months was required for inclusion. Forty-eight patients were identified; four were excluded due to insufficient follow-up. Diagnoses were: Graves’ disease (n=35; 79.5%), multinodular disease (MND) (n=8; 18.2%) and Amiodarone induced thyrotoxicosis (AIT) (n=1; 0.02%)....

Addison’s disease rarely newly presents during pregnancy. We highlight two cases diagnosed within 3 months. A 41-year-old with mild depression on Sertraline, presented at 11-weeks’ gestation with an 8-week history of fatigue, weight loss, dizziness and vomiting. Persistent hyponatraemia was noted (Na 122–127 mmol/l). Random cortisols were 298–428 nmol/l. Sertraline withdrawal and fluid restriction at another centre did not improve her hyponatraemia, the use...

A 35-year-old woman was referred with biochemical hyperthyroidism (T4 30 pmol/l; T3 7 pmol/l) without TSH suppression (5.4 mIU/l). She was 7 weeks pregnant following natural conception, and reported no symptoms of hyperthyroidism. Migraines had been a feature in very early pregnancy, but her medical history was otherwise unremarkable and there was no significant family history. Examination findings were entirely normal.Investigation...

Case history: A 51-year-old lady with a background of classical migraine and amenorrhoea conceived successfully via IVF, without prior endocrine assessment. Symptoms during the third trimester of pregnancy led to the diagnosis of a pituitary mass lesion (see Table). Possible differential diagnoses, on subsequent endocrine review, included macroprolactinoma, microprolactinoma with expansion during pregnancy, or lymphocytic hypophysitis.After 6 years of do...

Background: Reduced bone mineral density (BMD) z-scores from Dual energy X-Ray absorptiometry (DEXA) have been reported in childhood HSCT survivors. However, BMD z-scores are unreliable in patients with short stature.Objective: To investigate the influence of HSCT/TBI on size-corrected BMD in childhood leukaemia survivors.Method: Post-pubertal leukaemia survivors (16–26 years) treated with HSCT/TBI (10–1...

Background: Hyponatremia is the commonest electrolyte abnormality encountered in clinical practice. It is associated with increased mortality and prolonged length of stay. Errors in establishing the aetiology of hyponatremia can lead to inappropriate treatment with adverse outcomes. An accurate diagnosis requires a careful clinical and biochemical assessment. An audit was undertaken to determine current practice at University Hospitals Bristol.Method: A ...

Background: Adult survivors of childhood leukaemia treated with bone marrow transplantation and total body irradiation (BMT/TBI) have an increased risk of diabetes mellitus (DM) disproportionate to their level of adiposity or other recognised risk factors. Post prandial hyperglycaemia due to reduced β-cell reserve after irradiation will be missed by fasting glucose (FG) levels. However, the UK National Institute of Clinical Excellence (NICE) screening guidelines recommend...

Background: Adult survivors of childhood acute lymphoblastic leukaemia (ALL) treated with bone marrow transplantation (BMT) and total body irradiation (TBI) have increased risk of impaired glucose tolerance (IGT) and diabetes mellitus (DM). Insulin resistance (IR) has been described, but effects of TBI on pancreatic growth and β-cell function have not been previously reported.Method: Two groups of childhood ALL survivors were studied: Group 1, treat...