Endocrine Abstracts

Thyroid storm or thyrotoxic crisis is a manifestation of an extreme state of thyrotoxicosis. It is both rare and potentially fatal. Its presentation can be clouded by the precipitating illness and the involvement of one or more organ systems underlining the importance of clinical suspicion, early recognition and prompt intervention.We present a case of a 37-year-old man presenting to hospital with a community acquired chest infection that had not settled...

Introduction: Cardiovascular manifestations of hypocalcaemia include reversible CHF, prolonged QTc and ventricular arrhythmias. In patients presenting with hypocalcaemia, diagnosis of hypoparathyroidism is straightforward, but determining its cause is challenging.Case Report: 33 year lady admitted (23 November 2018) with VF arrest. Bloods showed low calcium (1.62 mmol/l), magnesium (0.48 mmol/l) and potassium (2.3 mmol/l) and ECG showed prolonged QTc. PT...

Introduction: Thyroid Hormone Resistance (THR) is a rare disorder caused by mutations of Thyroid Hormone Receptor characterised by insensitivity of target tissues to thyroid hormone actions. Patients can present with hyperthyroidism or hypothyroidism symptoms.Case report: 49 year lady with recurrent thyrotoxicosis with goitre (1989/1994/1998) treated elsewhere with CBZ/PTU and RAI (2001). She developed post-RAI hypothyroidism and at presentation to our O...

Introduction: Hypothyroid patients with failure to take/absorb oral levothyroxine might require intravenous levothyroxine. IV levothyroxine is neither licensed nor available in UK. It has to be imported (with special request), and is unexpectedly costly. IV liothyronine has shorter duration of action, need 2–3 injections/day, and exhibits sudden surges increasing risk of angina/arrhythmia. Moreover, IV liothyronine is much more expensive than IV levothyroxine.<p class...

Case history: A 33 year old lady with irregular menstrual cycles and infertility presented to gynaecologist with recurrent abdominal pain and bloating. Her pain was found secondary to bilateral ovarian cysts. She had repeated laparoscopic ovarian cystectomies since 2018. In December 2021, modest hyperprolactinemia (1065MIU/L, RR 102-496) with negative macroprolactin test was noted, and MRI pituitary revealed 18x17x13mm pituitary macroadenoma. Cabergoline was started and she wa...

A 33-year-old lady was referred to the endocrinology clinic with weight gain, hirsuitism and amenorrhea. She had been diagnosed with hypertension a year ago which was difficult to control despite being on three anti-hypertensive agents – Ramipril, Amlodipine and Bendroflumethazide. Past medical history included hypothyroidism secondary to radioactive-iodine therapy for Graves disease aged 22. Her GP organised an ultrasound scan querying polycystic ovaries but this reveale...

Parathyroid carcinoma is an uncommon cause of PTH-mediated hypercalcaemia, accounting for 0.5–5% of patients with primary hyperparathyroidism. We describe a case of parathyroid carcinoma where the usual pre-operative features of this condition were absent, and hence diagnosed on histopathology.A 72-year-old woman was referred to endocrinology with incidentally noted hypercalcaemia. Past medical history included hypothyroidism and essential hypertens...