Endocrine Abstracts

A 42 year old lady initially presented in Poland with haematuria while she was on holiday over Christmas. She had some tests including an ultrasound of the kidney which showed a mass adjacent to the left kidney. The haematuria had settled and she was feeling well apart from non-specific back ache. She worked in a cake factory which she continued to do here in the UK. Her GP requested another ultrasound of her kidneys which showed a solid mass adjacent to the left kidney and a ...

A 50-year-old half Jamaican gentleman was referred urgently to the endocrinology clinic with thyrotoxicosis. He had lost 2 stone in weight over a 2 month period and was complaining of lethargy, low libido and loose stools. His bloods showed a fT4>100 pmol/l, fT3 32.7 pmol/l, and TSH <0.02mU/l. Subsequently his TSH-R Ab returned elevated at 5.5IU/l (<2.9IU/l), confirming a diagnosis of Graves’ disease. His GP also checked his testosterone level on the initial b...

Long-term exposure to cortisol carry health risk and its important to establish the cause and exclude exogenous steroid use before starting investigation for endogenous causes, we present a young man with clinical picture of Cushing but low random cortisol.16 years old studying for his AS examinations at the time, presented to his GP with 5-week history of fatigue, weight gain of 2 stone in 18 months, insomnia, diarrhoea, left ...

Long-term exposure to cortisol carry health risk and its important to establish the cause and exclude exogenous steroid use before starting investigation for endogenous causes, we present a young man with clinical picture of Cushing but low random cortisol.16 years old studying for his AS examinations at the time, presented to his GP with 5-week history of fatigue, weight gain of 2 stone in 18 months, insomnia, diarrhoea, left ...

Background: We present a rare diagnosis of a patient presenting with Takotsubo cardiomyopathy and pituitary apoplexy. The case highlights the difficulty in management of a cardiac event with bleeding risk in a patient with these associated diagnoses.Case report: An 85-year-old woman was admitted to hospital with a severe frontal headache that woke her from sleep. She described chest pain associated with breathlessness later and was mildly confused. Sadly...

Phaeochromocytomas are rare catecholamine secreting tumours arising from the chromaffin cells of the adrenal medulla. The annual incidence is approximately 0.8 per 100,000 person-years. Most of them are sporadic but in about 25–30% of patients, they are part of a familial disorder. The classic clinical features are episodic headache, sweating and tachycardia (with or without hypertension). However, a minority of patients are asymptomatic. We present a clinical case in whi...

Alemtuzumab is the first humanised monoclonal antibody. It is used in haematological malignancies. It is associated with secondary autoimmune adverse effects including Grave’s disease, hypothyroidism, Goodpasture’s disease and ITP. We present a case where there was a drastic change in the thyroid biochemistry in a short span of few weeks- from raging free hormone levels to profound hypothyroidism. A 46 year old man was found to have abnormal th...

The milk – alkali syndrome was well known in the pre-proton pump inhibitor era when remedies for peptic ulcer included a large amount of calcium and sodium bicarbonate resulting in hypercalcaemia, metabolic alkalosis and often acute kidney injury. In a study done from 1998 to 2003, milk alkali syndrome was the cause of hypercalcaemia in 8.8 percent of the cases which is a significant percentage, so awareness about it is important.<p class="abste...

Severe Hypercalcaemia can present as a life threatening emergency requiring urgent measures to lower the calcium. Usually, this is associated with Primary Hyperparathyroidism. It can result in obtundation, oliguria, anuria, collapse or arrhythmias. It is important to act fast and decisively to prevent fatal complications.We describe a 39 year old gentleman who was a tennis coach, who was brought after he collapsed in his bathroom. ...

Moyamoya disease is a progressive chronic neurological disease due to multiple narrowing of the carotid arteries. It can be seen in association with atherosclerosis, vasculitis, haematological conditions, connective tissue disease, neurocutaneous syndromes and certain autoimmune diseases. Very few cases have been reported in association with Graves disease and the majority being in the East Asian population. We present a rare case of this association in a young C...