Endocrine Abstracts

Case History: A 26 year old female underwent Roux-en-Y gastric bypass (RYGB) surgery for intractable peptic ulcer disease on a background of obesity. She had a history of 40kg weight gain over 8 years (weight 123 kg, BMI 41.1 kg/m2), hypertension, depression, insomnia and newly diagnosed type 2 diabetes. Following surgery, weight loss was disappointing (nadir 112 kg, −11 kg, −8.9%TBW, −22.9%EBW, BMI 37.5 kg/m2) and diabetes and hypertens...

Stress hyperglycaemia is a widely recognised feature of critical illness. Spontaneous hypoglycaemia, by contrast, is an underappreciated but serious complication. Here I present three cases encountered over 12 months in a single teaching hospital.Case 1: 59 year old female. Admitted with fever and leg pain. Cellulitis diagnosed and antibiotics commenced. Hours later, she became unresponsive and shocked, with evident necrotisi...

Stress hyperglycaemia is a widely recognised feature of critical illness. Spontaneous hypoglycaemia, by contrast, is an underappreciated but serious complication. Here I present three cases encountered over 12 months in a single teaching hospital.Case 1: 59 year old female. Admitted with fever and leg pain. Cellulitis diagnosed and antibiotics commenced. Hours later, she became unresponsive and shocked, with evident necrotisi...

Hypothyroidism is common condition with a strong female preponderance and a UK prevalence of ~2%. It is normally treated with replacement oral levothyroxine.Morbid obesity is a costly public health issue with a prevalence in England of ~3% with two-thirds of sufferers being female. Weight loss surgery is increasingly employed as a successful and cost effective intervention for super-morbidly obese patients (BMI >40 kg/m2) in accordance wit...

Background: As per 2014 Endocrine Society guidelines, 131I-MIBG therapy is usually reserved for metastatic or unresectable disease in patients with pheochromocytoma / paraganglioma. In this series, we describe three patients effectively treated with primary 131I-MIBG therapy. The indications were primary neo-adjuvant therapy prior to surgery, or palliative.Case series: Case 1 – 18-year-old male with a 60 mm para-aortic paragang...

Case history: A 26 year old female with severe gastro-oesophageal reflux disease was seen in our service for assessment prior to roux-en-Y gastric bypass (RYGB) surgery for this condition. She had additional history of obesity, hypertension, insomnia, cholecystectomy for gallstones and anxiety-depression. At age 18 her weight was 85 kg, BMI 28 kg/m2. She gained 40 kg over the subsequent 8 years and in clinic was 123 kg, BMI 41.1 kg/m2 with a gynaecoid pat...

Background: Bariatric surgery is considered the most effective tool to manage the growing pandemic of obesity related health disorders. Lack of regular surveillance following bariatric procedures can put patients at risk of developing serious micro-nutritional deficiencies and related complications.Case report: A 51-year-old lady presented to the bariatric services in 2015 with long standing neurological symptoms including memory and cognitive impairment...

131I-metaiodobenzylguanide (MIBG) therapy, initially introduced in the 1980s, has emerged as a first-line to treatment of malignant phaeochromocytomas. Its other notable use has been in treating neuroblastomas occurring in childhood serving as an adjuvant prior to surgery or chemotherapy. An observed known late consequence of MIBG therapy is Primary ovarian failure (POI), characterised by menstrual irregularities over a period of 4 months associated with high Follicular stimul...

A 70-year-old female with known schizophrenia presented in hyperthyroid crisis. Examination revealed muscle wasting, tremor, sweating, low-grade fever, and sinus tachycardia. Biochemistry confirmed the diagnosis (TSH <0.1 mlU/l, thyroxine 41 pmol/l (9–25), tri-iodothyronine 25 pmol/l (3.5–6.5)). The patient was commenced on i.v. esmolol and carbimazole (40 mg) crushed into warm milk.However, lacking mental capacity, and refusing to take all...

Temozolomide has an established role as first line chemotherapy for aggressive pituitary adenoma and carcinoma. There are mixed reports whether the MGMT (methylguanine methyltransferase) and mismatch repair protein (MSH2/6) status of a tumour, assessed by immunohistochemistry (IHC) can predict response to temozolomide. This is the first series to assess combined MGMT and MSH2 status. We analysed a retrospective case series of patients treated with temozolomide at our tertiary ...