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 ...

Case history: 81-year-old female patient admitted for fracture neck of femur was referred to endocrinology for high T4. Clinically she was euthyroid with mild thyroid eye disease.PMH: Atrial fibrillation Post CABG 30.09.15, Hypothyroidism since 1983 (started on Eltroxin by GP for weight gain and tiredness though patient never had biochemical evidence of hypothyroidism), OA of spine 2007, T2DM, Asthma.Drug history: Amioda...

Case history: 62 Year old male known to have inflammatory bowel disease, ischemic cardiomyopathy, ICD implant for sustained ventricular tachycardia was referred to endocrine clinic by the GP for thyrotoxicosis which was found on lab workup for worsening diarrhoea and tiredness.Drug historyAmiodarone 200 mg od since 2012, Bisoprolol, Eplerenone, Atorvastain and Pentasa.Investigations: FT4 48.6 pmol/l (6.5&#150...

T3 regulates bone development and its actions are mediated by TRα and TRβ. Using TR knockout mice we demonstrated that TRα1 is the predominant mediator of T3 action in bone, although TRα2 (a non-T3 binding isoform of unknown function) and TRβ1 are also expressed in the skeleton. We show that mice lacking TRα2 have characteristic skeletal abnormalities of delayed closure of the skull sutures, abnormal clavicle development and reduced bone mineraliz...

HTLV-1 associated lymphoma is a rare but well recognised cause of life-threatening hypercalcaemia. It carries a very poor prognosis. We describe a case of a 47 year old Afro-Caribbean lady who presented with 3 months of fever, weight loss and right hip pain. She had a past medical history of quiescent sarcoidosis diagnosed 20 years previously. She also suffered from systemic lupus erythematosus, for which she was taking methotrexate and 20 mg of prednisolone. She also had hype...

Introduction: Mast cells are critical effectors in inflammatory diseases, including cardiovascular and metabolic diseases and their associated complications. These cells exert their physiological and pathological activities by releasing granules containing histamine, cytokines, chemokines, and proteases, including mast cell-specific chymases and tryptases.Aim of the study: To detect the role of mast cell in diabetic obese and correlation to different dia...

A 19-year-old female presented with DKA. She had developed T1DM aged 5. She had an HbA1c of 12.9%, and numerous previous admissions with DKA. There was no other past medical history of note. She took 162 units of insulin/day, as a basal-bolus regime. She took no recreational drugs or other medications. She consumed up to 10 units of alcohol a week. On clinical assessment and investigation, there was no evidence of sepsis, and she was treated with intravenous insulin and fluids...

Background: Hyponatremia is the commonest electrolyte abnormality encountered in clinical practice. It is associated with increased mortality and prolonged length of stay. Errors in establishing the aetiology of hyponatremia can lead to inappropriate treatment with adverse outcomes. An accurate diagnosis requires a careful clinical and biochemical assessment. An audit was undertaken to determine current practice at University Hospitals Bristol.Method: A ...

Antipsychotic induced hyperprolactinaemia, mediated by blockade of dopamine D2 receptors, is much more common than prolactinoma in patients receiving antipsychotic medication. We present two cases of the latter.Case 1: A 47-year-old gentleman with depression treated with amitriptyline, fluoxetine and risperidone presented with headaches and a left sided visual field defect. Pituitary MRI showed a 2 cm macroadenoma abutting the optic chiasm. Prolactin was...

A 69-year-old lady presented with pancreatitis, which was managed conservatively and resolved. However, imaging identified a 4 cm left adrenal lesion. She had no features of Cushing’s syndrome, and was normotensive, but serum potassium was low. Renin:aldosterone ratio was normal. She failed a low dose dexamethasone suppression test (LDDST). She underwent laparoscopic adrenalectomy. Histology showed an adrenocortical carcinoma extending into the adjacent adipose tissue. Si...