Endocrine Abstracts

Case history: A 38 years old Afro-Caribbean gentleman presented in June 2018 with symptoms of hyperthyroidism. He is a smoker and takes alcohol occasionally. Examination revealed fine tremors, tachycardia, moderate sized goitre with no thyroid bruit and right sided proptosis. Thyroid workup revealed suppressed TSH, raised free T4 and TRAb of 9.75 IU/L suggesting Graves’ Thyrotoxicosis. He was started on 20 mg of Carbimazole (CBZ)OD with Propanolol. After initiating carbim...

An 82 year old gentleman was admitted with lethargy, shortness of breath and weight loss of 26% total body weight over a two-year period. His past medical history included hypertension, pulmonary fibrosis, thalassaemia trait and unexplained thrombocytopenia.He had previously been investigated for weight loss with a CT thorax/abdomen/pelvis in 2014 which demonstrated no evidence of malignancy and FDG PET had shown no disease.On admi...

Introduction: Adrenal venous sampling (AVS) is the reference standard test to differentiate between unilateral and bilateral adrenal diseases in patients with primary hyperaldosteronism. Current Endocrine society guidelines recommend AVS in all cases of primary hyperaldosteronism where surgery is desirable and practical. However, this procedure is technically challenging and failure rate is high.Aims: The aim of this audit was to evaluate success rate of...

Case History: 38 year old male presented with thyrotoxic symptoms and exophthalmos with an initial Free T4 of > 100 pmol/l; TSH < 0.01 mIU/l and thyroid receptor antibody positivity. He had a platelet count of 72* 109 /L at presentation and was started on carbimazole. A month later he had platelet count of 9* 109 /L with normal white cell count and haemoglobin levels. He was switched to propylthiouracil, but was readmitted with platelet count of 1...

An 84 year old female with a known history of chronic kidney disease (stage IV) and benign lung tumour presented to the Emergency Department with collapse. She had suffered recurrent collapse over the previous 2 years. Of note she reported significant weight gain during this period. She was diagnosed with symptomatic hypoglycaemia (venous blood glucose 2.8 mmol/l). She was admitted to the ward and found to have recurrent hypoglycaemia both when fasting and post-prandial.<p...

Introduction: Periodic paralysis is a rare condition characterized by muscle weakness in the presence of triggers including cold, heat, high carbohydrate meals or physical activity. It is classically described in the presence of profound hypokalaemia; when this occurs in conjunction with thyrotoxicosis it is termed thyrotoxic periodic paralysis.Case history: A 30-year old Nigerian man presented with a 3 h history of inability to move, on a background of ...

Introduction: Radioiodine is a safe and effective treatment for benign thyroid disease. It aims to treat hyperthyroidism and achieve a euthyroid state. Radioiodine is indicated in cases of hyperthyroidism caused by Graves’ disease or toxic goitre (solitary toxic adenomas or multi-nodular goitre). In practice there has been concerns about long term safety, worsening of eye disease and weight gain with this treatment.Aims: To audit outcome, management...

Objective: A review of the efficacy and safety of radioiodine treatment for Graves’ disease.Methodology: Patients were identified following a search of the nuclear medicine departmental database. Consecutive patients who had radioiodine in 3-year period from January 2009 to December 2011 were included in the audit. Information was obtained from medical notes, blood results and nuclear medicine database. Data was analysed using Microsoft Excel.<p...

Aims and Objectives: We conducted a study of 71 patients with Primary Hyperparathyroidism being managed in a single site Joint Endocrine Service. We sought to review the adherence to current international guidelines in managing these cases, and the effectiveness of pre-operative localization to inform surgical options.Results: A total of 71 cases were reviewed, of whom 35 were managed conservatively and 36 underwent surgery. Every patient undergoing surg...