Endocrine Abstracts

A 38-year old lady from the Philippines presented with a 2-year history of a painless thyroid lump, without pressure symptoms. Over the previous year it had gradually enlarged in size. She gave a history of disturbed sleep, tremor, anxiety and weight loss over the 2-year period. Past medical history included right middle lobectomy for bronchiectasis 10 years previously. Thyroid function tests revealed TSH<0.05 mu/l, FT4 86 pmol/l, FT3 18.3 pmol/l and ...

Objective: To describe the clinical presentation of forefoot and midfoot diabetic foot ulcers (DFUs) complicated by osteomyelitis and their outcomes with conservative management in a multi-disciplinary care environment and determine predictors of ulcer healing.Methods: This is a retrospective study of all consecutive cases of DFUs complicated by osteomyelitis presenting to our multi-disciplinary diabetes foot clinic between 1st January and 30th June 2016...

Thyroid nodules are common in the general population. In 2006, we audited and discovered that primary care direct access to thyroid ultrasound (TUS) has limited value in detecting sinister thyroid pathology. To improve quality of thyroid nodule management, in May 2007, we introduced four changes (1) appointed a thyroid MDT coordinator, (2) produced a thyroid nodule proforma to guide primary care referrals, (3) established the rapid access one-stop thyroid ultrasound FNA clinic...

A 59-year-old lady presented with significant weight gain, and a history of hypertension for investigation of possible Cushing’s syndrome. Her BMI was 29, with mainly central obesity. Initial tests revealed elevated untimed cortisol on two separate occasions, at 905 nmol/l and 893 respectively with detectable midnight cortisol, at 548 and 481. Of 24-hour urinary free cortisol (UFC) was also elevated on two separate occasions, at 931 nmol/24 h and 827 respectively. ACTH wa...

A 29-year-old lady with known autoimmune thyrotoxicosis (TPO 712 IU/ml) presented with an urticarial rash. She was on carbimazole. A diagnosis of drug-induced reaction was suspected and treated as such. Her carbimazole was discontinued. After a day of treatment with steroids and antihistamines, she experienced flushing, orthostatic hypotension and difficulty in breathing. She was treated for anaphylaxis with adrenaline on intensive care unit. A formal Dermatology opinion was p...