Endocrine Abstracts

Resistance to thyroid hormone (THR) is a rare genetic condition affecting the nuclear thyroid hormone receptor, and inherited in a dominant negative pattern. It is often diagnosed in patients with discordant thyroid function. Patients have a ‘pituitary resistance’ to the elevated circulating levels of thyroid hormone, resulting in the failure of TSH suppression. While this consequent TSH drive has been associated with follicular thyroid cancer, it is thought that coe...

Introduction: Central hypothyroidism is frequently seen after pituitary surgery, radiation therapy or head injury. We present a case of silent thyroiditis in a patient with secondary hypothyroidism. Case Description A 24 year old woman complained of tiredness during her periodic review in the endocrine clinic. Her endocrine history included surgery for craniopharyngioma at the age of 3 years and subsequent hypopituitarism with growth hormone, ACTH deficiency, diabetes insipidu...

Introduction: Carcinoid tumours commonly originate from the gastrointestinal tract. Cardiac manifestations occur in 10–41% of patients with carcinoid syndrome, usually associated with liver metastases. We report an atypical case of a carcinoid tumour associated with right sided heart disease without distant metastases.Case description: A 75-year-old lady with no significant past medical history and a lifelong non-smoker, was admitted with 3 months h...

Introduction: Hyperglycaemia induced elevation in alanine aminotransferase (ALT) in people with type 1 diabetes has been well described in children but is a less recognised complication in adults.CaseAn 18 year old slim girl was admitted to hospital with diabetic ketoacidosis (DKA). She had type 1 diabetes for 16 years and recurrent hospital admissions with DKA. Her HbA1C was 126 mmol/mol. After correction of her DKA and restarting...

Introduction: Preoperative ultrasonography or Sestamibi scanning (or both) of the parathyroid glands could facilitate a focused or minimally invasive surgical approach. In this audit, we wanted to find out whether one form of imaging is superior to the other in correctly identifying a parathyroid adenoma, later confirmed on histology.Methods: Data were collected from consecutive patients who underwent parathyroidectomy for primary hyperparathyroidism, co...

Introduction: Phaeochromocytomas commonly present with episodes of sweating, palpitations, and hypertension. Urinary catecholamines measurement is the most common screening test for suspected phaeochromocytoma in the UK. We report a series of three cases in which the reason for hypertension and raised catecholamines was not a phaeochromocytoma and treating the underlying condition corrected the clinical and biochemical abnormality.Cases: Three patients w...

Introduction: Obstructive Sleep Apnoea (OSA) is more common in women with Polycystic Ovary Syndrome (PCOS). There is paucity of data regarding the impact of OSA in women with PCOS.Methods: We conducted a retrospective study using electronic patients’ records of premenopausal women with PCOS who were first seen in the weight management clinic (WMC) between March/2008 and November/2014. PCOS diagnosis was documented either by referring clinician or es...

Introduction: Normocalcemic hyperparathyroidism is a less recognised variation of primary hyperparathyroidism (pHPT). Patients present with normal calcium and elevated level of PTH.Case: A 70 years old woman presented to her general practitioner with left sided loin pain. She had no past medical history of note and she was not taking any medications. Ultrasound of the urinary tract showed bilateral nephrocalcinosis. Her blood tests showed raised PTH leve...

Background: Women with polycystic ovary syndrome (PCOS) are commonly associated with insulin resistance, metabolic syndrome and a family history of diabetes mellitus (DM). They are therefore at risk of diabetes and dyslipidaemia. Diabetes UK (2006) recommends screening for diabetes in PCOS patients who have a body mass index (BMI) ≥30. The recommended test is fasting plasma glucose (FPG). We therefore investigated 55 PCOS patients and 33 healthy volunteers to test the hy...

Introduction: With increased biochemical screening primary hyperparathyroidism (pHPT) is discovered incidentally while patients are still asymptomatic.Objective: To assess the impact of surgery on neuropsychological symptoms in people with apparent asymptomatic pHPT.Methods: Twenty-four patients with asymptomatic pHPT requiring parathyroidectomy, in accordance with NIH recommendations, were recruited prospectively between May 2005 ...