Endocrine Abstracts

A case of a 48-year-old lady who is under follow-up in the clinic at Causeway Hospital, Northern Ireland for hyperthyroidism. She has a medical history of SLE under follow-up Rheumatologists and bronchial asthma. She presented with palpitations, tremors, sweating, and heat intolerance. On examination, the patient appears anxious. Blood pressure was 130/80, PR 140, RR 20, T 37, SPO2 98% A. Her eye examination revealed no lid lag, exophthalmos, and no redness. Examination of the...

We present a 50-year-old man who was referred to endocrine clinic with painful gynaecomastia of 3 months duration. He was waiting hip replacement. He had history of a lump in his left breast 9 years ago. He had USS and FNA. He was treated with some tablets for a month and discharged from breast clinic. He had no other past medical history. He worked as a physical trainer to metropolitan police. He did not smoke or drink and was on no medication. He had never used recreational ...

Thyroidectomy is a definitive form of treatment for patients with hyperthyroid Graves’ disease particularly those who are noncompliant with or have serious side effects to the antithyroid drugs, have very large goitres, refuse 131I therapy or, have moderate to severe ophthalmopathy. The risk of perioperative thyroid storm is usually higher following an acute event such as surgery, trauma, or infection. Thus, patients with thyrotoxicosis presenting for surgery should ideal...

A 19 year old Caucasian male presented with nausea and malaise. In the past medical history he had been obese since childhood with hyperphagia and abnormal food seeking behaviour. His father was obese and had type I diabetes mellitus. His mother was also obese and had impaired glucose tolerance.On examination he was morbidly obese (body mass index 46.9 Kg/M2) and had axillary acanthosis nigracans. He had clinical features of hypovolaemic shock...

Beta-human chorionic gonadotropin (β-hCG) is normally produced by syncytiotrophoblasts of the placenta and may also be secreted by germ cell neoplasms. An increase of serum hCG concentration in a male patient often suggests malignant neoplasms with a trophoblastic element. Common examples include classic seminoma with syncytiotrophoblast-like giant cells, combined germ cell tumour, and choriocarcinoma. Non-gestational choriocarcinomas typically arise from gonadal...

Background: A four-tiered system is currently in place for weight management in the National Health Service (NHS). Tier 3 comprises specialist weight management services and aims for a clinically meaningful weight loss of ≥5%, as recommended by the National Institute for Health and Care Excellence (NICE). Within the Imperial Weight Centre (IWC), patients receive support from a multi-disciplinary team including endocrinologists, surgeons, dietitians, nurs...

The VHL gene is a tumor suppressor gene located on chromosome 3p25.3. Mutations in this gene prevent production of the VHL protein and as a result, cells grow and divide uncontrollably to form the tumors and cysts. Germline VHL gene mutations predispose to a variety of tumors, most commonly retinal and cerebellar haemangioblastomas, renal cell carcinoma and phaeochromocytoma. Papillary cystadenomas of the epidididymis are seen in 10–26% of men are rarely...

A 60 year old Caucasian woman presented with a three month history of rapidly enlarging neck swelling and hoarseness of voice. Her past medical history included Hypothyroidism. Her neck ultrasound scans showed 3.5 cm left thyroid nodule with bilateral lymphadenopathy (U5). The Fine needle aspiration (FNA) revealed densely grouped variable sized irregular epithelial cells with nuclear atypia and spindle shaped fragments with focal areas of lymphocytic thyroiditis. The different...

A 72-year-old gentleman was diagnosed with primary hyperparathyroidism in 2005. He had 6 admissions in a year with hypercalcaemia refractory to treatment with conventional agents. On each admission he was treated with intravenous pamidronate and fluid resuscitation. This resulted in an average stay of 16 days and an average cost of £4800 per admission.A single parathyroid adenoma was diagnosed on sestambiscan. He was not considered fit for surgery d...

Schizophrenia is associated with higher risk of Type 2 diabetes. There are several reports of Type 2 diabetes presenting as diabetic ketoacidosis, particularly in young obese African-Caribbean subjects. We report 3 cases of new onset diabetes presenting with diabetic ketoacidosis (see Table 1) in African-Caribbean males treated with olanzapine for chronic schizophrenia.Table 1 Metabolic parameters on admissionCase</td...