Endocrine Abstracts

Skeletal muscle infarction is an uncommon manifestation of poor diabetic control. This report describes a gentleman who presented with two weeks of thigh pain and swelling, and had been referred to hospital for exclusion of deep vein thrombosis (DVT). His right thigh was markedly swollen, but soft. There was marked tenderness at the medial aspect. Right thigh circumference was 61 cm, while the left was 48.5 cm. There was no warmth or erythema. He had a full range of movements ...

A 49-year-old female was admitted to medical HDU with diabetes ketoacidosis (DKA) and newly diagnosed diabetes. Six months previously she was diagnosed with malignant hypertension. She had poorly controlled blood pressure despite treatment with four anti-hypertensives, which were her only regular medication. She had never used any medications or creams containing glucocorticoids. She had no history of hypokalaemia and reported no use of liquorice. She recently attended an outp...

A 46-year-old Columbian man, with a previous history of pulmonary sarcoid and renal calculi in 2001, was referred to the Endocrinology clinic in 2005 with persistent hypercalcaemia despite successful treatment of the sarcoid. The initial hypercalcaemia work-up results were as follows: adjusted calcium 2.96 (2.15–2.60), parathyroid hormone (PTH) 9.0 pmol/l (1.1–6.8), 25-(OH)2 vitamin D 71 nmol/l (>50), magnesium 0.99mmol/l (0.65–1.00), creatinine 97 umol/l...

A 53-year-old Asian supermarket produce supervisor was noted at work to have slurred speech, sweating, and to feel lightheaded. Paramedics were called and on arrival his capillary blood glucose (CBG) was 1.7 mmol/l. This rose to 2.7 mmol/l after he was given glucose gel followed by complex carbohydrate. He remained lightheaded so was taken to hospital. CBG on admission was 2.0 mmol/l, so samples were taken for plasma glucose, insulin, C-peptide and sulphonylurea screen. Plasma...

Radioactive iodine (RAI) therapy is the usual treatment of choice for hyperthyroidism. We have demonstrated a success rate of 88% (euthyroidism or hypothyroidism) over a 5-year period. We are very happy to recommend RAI, however patients still express concerns.There is little literature available about patients’ reactions to RAI: to our knowledge, only two studies. We performed a survey of our RAI treated patients. Of 143 patients contacted, 87 repl...

A 58-year old previously independent man with background of poorly-controlled hypothyroidism, T2DM, hypertension, ischaemic cardiomyopathy, and CKD presented to hospital feeling generally unwell, with a dry cough. His regular medications included anti-hypertensives, L-thyroxine 50 μg daily, linagliptin, insulin, aspirin, atorvastatin, and thiamine. On admission, the TSH was 83 mIU/l, free T4 6.5 pmol/l and free T3 was 1.9 pmol/l; four months earlier, the TS...

Background: The incidence of thyroid cancer is increasing globally mainly due to increased detection of papillary microcarcinoma. The British Thyroid Association (BTA) guideline (2014) recommends the use of U1-U5 classification on ultrasound to assess thyroid cancer risk. U3 nodules have low, but indeterminate risk and therefore need FNAC. This retrospective review analyses the outcome of U3 nodules in an outer London hospital.Methods: Thyroid ultrasound...