Endocrine Abstracts

Myxoedema coma is a rare endocrine emergency with reported high mortality. Exact incidence is hampered by no clear consensus on its definition and the huge variability in its presentation. Most patients are not comatose, and have a form of severe, decompensated hypothyroidism. The common clinical features, including poor mentation, hypothermia, haemodynamic instability and lethargy, correlate poorly to degree of biochemical hypothyroidism. Early detection and identifying commo...

Myxoedema coma is a rare endocrine emergency with reported high mortality. Exact incidence is hampered by no clear consensus on its definition and the huge variability in its presentation. Most patients are not comatose, and have a form of severe, decompensated hypothyroidism. The common clinical features, including poor mentation, hypothermia, haemodynamic instability and lethargy, correlate poorly to degree of biochemical hypothyroidism. Early detection and identifying commo...

Shared, informed decision making is a key component to high quality care in the NHS. This can occasionally be challenging through lack of time, lack of high-quality trial evidence to support treatment choices and financial limitations to treatment. Informed decision making includes open discussion of the risks and potential adverser consequences of treatment and alternatives. People with endocrine disorders often have symptoms that encompass both their psychological and physic...

Society for Endocrinology peer review is in its 16th year. In 2018 the format has been updated and single centre reviews are now being carried out. The catchment area of hospitals reviewed has varied from 280 000 to 2.5 million. A review helps to highlight a centre’s strengths and help focus on areas for development. It is a qualitative deep dive into a service which includes benchmarking against other similar services. The review is conducted by a team of clinical endocr...

The need for Peer Review of UK endocrine units was agreed by the Clinical Committee of the Society for Endocrinology in 2001. The service is relevant to the agendas of clinical governance in endocrinology, and ensuring good quality universal care across the UK for patients. Peer Review presents an opportunity to improve patient care, support and facilitate service provision and innovation. Since Covid-19 (2020) there has been significant changes to the way we work and peer rev...

Background: Insulin like growth factor-2 (IGF-2) has structural similarity to insulin1. In excess, IGF-2 can activate glucose metabolism so precipitating hypoglycaemia1.Case Presentation: Six days following her second dose of Doxorubicin and Olaratumab therapy for a pelvic sarcoma, HS presented with two successive days of acute confusion secondary to documented hypoglycaemia (blood sugars 2.0-3.1 mmol/l, 36-55.8 mg/dl). Despite treatment, she had recurre...

Introduction: α 19-year-old female patient with no past medical history presented with multiple collapses following exercise due to hypoglycaemia. From the history it transpired that she had had previous symptoms consistent with hypoglycaemia on multiple occasions, with no relation to fasting or food or a specific diurnal or nocturnal pattern. The two most severe episodes (requiring paramedic treatment) were in the recovery period from anaerobic exercise. Her body mass in...

Background: Recent NICE guidelines1 suggest imaging the parathyroid with ultrasound as first line prior to parathyroidectomy, MIBI as an alternative and surgical exploration if discordant. Investigation should also include a renal ultrasound and DEXA. This audit compares a single surgeon practice in one hospital to the guidelines.Methods and Results: All patients with a parathyroidectomy performed by a single surgeon between July 2016 and July...

Introduction: Turners’ syndrome (TS) affects one in 2500 live births. Multiple comorbidities affect TS patients and recommendations for long-term management advocate annual review with a ‘checklist’ approach. This audit of current practice of a specialist TS clinic aims to identify gaps in patients’ management.Methods: A checklist of recommendations for health screening based on the National Turner’s Syndrome Guidelines was devel...

A 51-year-old gentleman presented in June 2022 with pneumobilia, staph liver abscesses and rapidly conducted atrial fibrillation requiring ITU admission. He had a 2-year history of typical Cushingoid features and hypogonadism, 4 agent hypertension since 2012, fragility fractures, previous renal calculi, pulmonary emboli and diabetes. He had not been able to walk unaided for a year (was mobilising with crutches on admission). In retrospect, he had previously had a cortisol of 7...