Endocrine Abstracts

A 27 year old lady with Graves’ thyrotoxicosis (fT4 50.3 pmol/L, fT3 25.0 pmol/L, TSH<0.05 mU/L) failed to respond adequately to carbimazole (40 mg BD) or propylthiouracil (250 mg QDS). Three months later, following 10 days of potassium iodide to render her biochemically euthyroid, she underwent a total thyroidectomy. Pre-operative bone profile revealed Ca(c) 2.34 mmol/L (NR 2.15–2.60 mmol/L), phosphate 1.36 mmol/L (NR 0.8–1.4 mmol/L), PTH 3.4 pmol/L (NR 1.1...

Case report: A 7-year-old girl presented with short stature following removal to the UK from China, where she had been diagnosed with GH deficiency on blood testing, for which GH treatment had been recommended. She had reportedly not grown well over the previous 2 years, and though the oldest in her class, she was the smallest. She had a poor appetite but otherwise was well. She had no constipation, normal activity levels, and was doing well in school. She was born at term wei...

A 52-year-old, previously well Indian lady was admitted in May 2008 with pneumonia. Concurrently, she was diagnosed with diabetes mellitus (blood glucose 20 mmol/l). Her BMI was 19 kg/m2 and she was initially commenced onto sulphonylurea therapy. She had a further admission in July 2008 with dizzy episodes, falls, postural hypotension (systolic postural drop 75 mmHg) and erratic blood glucose levels (range 1.1–30 mmol/l). Blood ketones were 3.6 mmol/l without a...

AbstractContinuous subcutaneous insulin infusion (insulin pump therapy) is recommended as a treatment option for patients with type 1 diabetes where multiple-dose insulin therapy has failed. These patients are looked after by a specialist multi-disciplinary team and those receiving this treatment should have the commitment and competence to use the pump effectively.We carried out a retrospective study on 33 paediat...

Introduction: Congenital adrenal hyperplasia (CAH) is autosomal recessively inherited with a world-wide incidence of 1:10 000–1:20 000 births.Objectives: To document the prevalence of clinically diagnosed CAH and describe the spectrum of the condition in Sri Lankan children.Method: Request letters were sent to all paediatricians in state-sector hospitals to report details of children <16 years with CAH under their care. St...

Introduction: The presence of heterophilic antibodies resulting in assay interference could lead to falsely high or low values in biochemical investigations. We present a case of a 5-year-old girl who had persistently high level of TSH despite Levothyroxine treatment.History: A five-year girl was found to have an elevated plasma TSH level (24.29 mU/L) with normal Free T4 (both measured using Abbott Alinity immunoassay) w...

Background: Adrenocortical carcinoma in childhood is a rare tumour which accounts for about 0.2% of all paediatric malignancies. Affected children usually present with virilization, cushingoid features, and/or mineralocorticoid excess. We present a boy with adrenal carcinoma presented with virilization and unusually suppressed cortisol at initial presentation.Case report: A two-year-old boy presented with pubic hair, acne, and increased penile growth wit...

Background: While pituitary adenomas are the commonest Sella neoplasm, number of other entities should be considered in the differential diagnosis and the diagnosis is based on histopathological and immunohistochemical characteristics. Pituitary tumors with papillary architecture are uncommon and have limited differential diagnoses. Primary papillary epithelial tumor of the pituitary is a recently described histopathological entity with striking papillary architecture and TTF1...

Background: Hypogonadotropic hypogonadism (HH) is one of the few treatable causes of male infertility; spermatogenesis induction can be achieved with gonadotrophins or pulsatile GnRH. Treatment protocols are normally long, and outcome varies according to the underlying aetiology, age of onset and history of undescended testes. Regular follow-ups are needed to assess the response and monitor for adverse effects of therapy that could make the management challenging.<p class=...

Background: Thyroid cancer commonly presents as a new palpable thyroid nodule or increase in size of a pre-existing nodule. A multidisciplinary thyroid lump clinic was established in September 2008 enabling patients to have one-stop clinical, biochemical, radiological and cytological assessment for evaluation of thyroid nodules. This audit predates this period, aiming to provide background information for future audit.Aim: To evaluate the requests for th...