Endocrine Abstracts

Background: Hyperthyroidism is a thyroid hormone excess state which usually manifests with various cardiovascular complications such as sinus tachycardia, tachyarrhythmia and high output cardiac failure. Pulmonary embolism is not commonly associated with thyrotoxicosis but some studies have shown an increased propensity of thromboembolic disease with thyrotoxicosis. We rep...

Background: Primary hyperparathyroidism is one of the most common disorders encountered in endocrine clinics and primarily affects women. The current recommendation for patients with primary hyperparathyroidism is to undergo parathyroidectomy which has a 97% success rate. However, there is a small group of patients where surgery is contraindicated, or patients who have a disease pattern not amenable to surgery or patients who refuse surgery. These patients would require an alt...

Diabetes education plays a vital role especially in newly diagnosed patients to prevent long-term complications and hospital admissions. We present a 68-year old female who was admitted with nausea, vomiting and poor oral intake. She was discharged two weeks ago after having complete pancreatectomy, splenectomy and left adrenalectomy for pancreatic cancer and a left adrenal mass. She did not have past medical history of diabetes and was commenced on basal bolus insulin after s...

Thyroiditis can often lead to initial thyrotoxicosis and it is important to differentiate among the causes as many cases do not require antithyroid drugs. We present a case report of a 48 year old lady who presented with 10 days history of fever, fatigue, myalgia and a painful goitre after returning from a cruise at Caribbean. Examinations showed pyrexia of 38 C but no localising signs of infection. She had a smooth tender goitre and no signs of thyrotoxicosis. Investigations ...

Background: Post-operative hypoparathyroidism is a known complication of total thyroidectomy. It can either be transient or long-term requiring lifelong treatment. Delayed presentation of hypoparathyroidism occurring after several years of surgery is rare, with only a few cases reported in literature but can be life-threatening.Presentation: We report a case of a 70-year-old female presenting with features of hypocalcaemia (tinnitus and tingling in her f...

Background: Hyponatraemia is encountered in 15−20% of inpatients but remains suboptimally managed. It leads to increased morbidity, length of stay and mortality. A closed-loop audit on investigating and managing inpatients with hyponatraemia was conducted, to identify pitfalls in management.Method: A retrospective audit of general medical inpatients admitted over three months with a serum sodium level of less than 130 mmol/l was conducted. Relevant...

Background: The prevalence of hypothyroidism is around 1–2% in the UK. Hashimoto’s thyroiditis is thought to cause 0.1–2% of overt disease and 10–15% of subclinical hypothyroidism. This case presents a patient with severe hypothyroidism, secondary to Hashimoto’s thyroiditis, found incidentally on a surgical admission. The case study discusses the challenges and management of severe hypothyroidism in the need for an acute surgical intervention....

Background: Graves’ disease is a common cause of thyrotoxicosis,especially amongst females. In the UK,initial treatment is usually with anti-thyroid drugs, using either a ‘block and replace’ or a titrating regime. A meta-analysis suggests about 50% chance of relapse after the initial course of treatment and may then require definitive cure with radioactive iodine or surgery.Method: A retrospective audit of patients with Graves’ di...

Background: While dopamine agonists (DAs) are used for managing residual/recurrent non-functioning pituitary adenomas (NFPAs), guidance on patient selection, drug dosing, follow-up imaging and response criteria is lacking.Methods: Retrospective review of NFPAs treated with DAs at a U.K single centre. 14 patients on Cabergoline (November 2011-2022) were identified. Radiological response was based on 2 follow-up (FU) scans...