Endocrine Abstracts

Most patients with vitamin D deficiency and osteomalacia have elevated parathyroid levels with normal or low serum calciums .This hyperparathyroidism is described as secondary hyperparathyroidism and resolves with correction of vitamin deficiency. We describe three cases where there was coexistant osteomalacia vitamin D deficiency, elevated parathyroid hormone and hypercalcaemia.Case 1A 40 year old Asian female presented with a six...

Primary Hyperparathyroidism is a common endocrine disorder. It is due to a single parathyroid adenoma in 80%, most of the remainder due to hyperplasia of all four parathyroid glands. The only curative procedure is a parathyroidectomy, but pre-operative localisation can be difficult. Isotope scanning with sestaMIBI is considered to be useful in localising any parathyroid adenoma to help guide surgery.All patients having isotope parathyroid scans over a th...

Primary hyperaldosteronism (PHA), accounts for 5–10% of all hypertensive patients and is associated with increased cardiovascular risk. However, making the diagnosis is not always straightforward.A 50-year-old male was admitted with an acute myocardial infarct. He was markedly hypertensive (BP 190/100 mmHg) and hypokalemic. He was commenced on beta-blockers and an Angiotensin converting enzyme inhibitor (ACEI). Plasma aldosterone concentratio...

Adipocytes have a key role in obesity and precursor cells can differentiate into white or brown adipocytes, with different metabolic functions. However the process by which stem cells commit to these lineages, and the factors that distinguish white adipogenesis from brown, are poorly understood.Fetal mesenchymal stem cells (fMSCs) can differentiate into adipocytes, but neither the regulation of this process, nor the phenotype differentiated cells has bee...

The National Service Framework (NSF) for Diabetes requires that type II diabetes patients are actively involved in their diabetes management. The use of patient-held, integrated care plans is envisaged to encourage patients to actively participate in their diabetes management and to facilitate the flow of information between primary and secondary care. However, the utility of such schemes may be limited by the current level of patient education regarding the data recorded in t...

The National Service Framework (NSF) for Diabetes requires that type II diabetes patients are actively involved in their diabetes management. The use of patient-held, integrated care plans is envisaged to encourage patients to actively participate in their diabetes management and to facilitate the flow of information between primary and secondary care. However, the utility of such schemes may be limited by the current level of patient education regarding the data recorded in t...

Pre-operative localisation of insulinomas is essential prior to resection. Many imaging modalities have been used. Angiography is well described for localising neuroendocrine tumours and the use of selective intrarterial calcium injection to stimulate insulin release with simultaneous sampling of insulin levels in the hepatic vein has been shown to allow localisation of the tumour to particular vascular territories, even when other modalities have not been helpful.<p class...

A 21 year-old woman of Indian descent, but UK born and bread presented with a two-year history of intermittent headaches, hot flushes, polydipsia, nocturia and amenorrhoea. One year previously she had been diagnosed with primary hypothyroidism with a TSH of 7.3 and FT4 of 6.5. She was treated with thyroxine but remained amenorrhoeic.Subsequent evaluation revealed TSH, LH, and FSH deficiency with evidence of cranial diabetes insipidus. An MRI scan of the ...

Case history: A 55 year-old female presented to A&E with left iliac fossa pain and vomiting, 8 days following her first dose of the AstraZeneca COVID-19 vaccine. She had a background of hypothyroidism, hypertension and hysterectomy for menorrhagia at age 25 – no prior thrombotic history. She underwent emergency laparoscopy for suspected torsion, which was converted to laparotomy for ovarian necrosis secondary to left ovarian vein thrombosis. Post-operatively, isolated...

A 60-year-old gentleman who had previously undergone a right nephrectomy for renal cell carcinoma was admitted electively for a left adrenalectomy due to metastatic disease. Prior to this he had been treated with immunotherapy (Sunitinib) and radiotherapy for pulmonary and bony metastases respectively. He was given perioperative cover with hydrocortisone. A short synacthen test (SST) performed the morning after discontinuing hydrocortisone showed a baseline cortisol of 406 nmo...