Endocrine Abstracts

A 24-year-old lady was diagnosed with thyrotoxicosis following an emergency admission, with a normal laparotomy, for right iliac fosa pain. She was commenced on carbimazole. After self discontinuation of carbimazole she was re-referred, by her GP, with poorly controlled thyrotoxicosis and typical features of weight loss, anxiety, oligomenorrhoea and tremor. Her FT4 on re referral was 60 pmol/l, suppressed TSH and raised TPO antibodies. She then had an unplanned pregnancy which...

Presenting the complex journey of a 36 year old lady who following over 2 years of symptoms was found to have raised IGF1 and prolactin. She had microscopic transsphenoidal resection of pituitary adenoma. This was followed by different medical therapies and Gamma knife radiotherapy. She was also referred to many other specialists for Acromegaly related conditions and surveillance. The pathway to diagnosis can be full of barriers and may take many years for a patient to travel ...

A third of UK residents develop cancer, but the risk of being diagnosed under age 50 years is under 4%. The four most common cancers account for 54% of all cases: breast (16%), lung (13%), colorectal (13%) and prostate (12%). Five-year age standardised survival has increased substantially in recent decades for breast, prostate and colorectal cancer resulting in latest figures of 77, 65 and 48%, respectively. Cancer is increasingly becoming a curable or chronic disease. At the ...

Phosphoinositide 3-kinase (PI3K) signalling pathways are now accepted to be widely important in the mechanisms by which a variety of cell surface receptors can regulate critical cellular functions, such as cell growth, survival and movement. Class I PI3Ks generate the messenger lipids PtdIns(3,4,5)P3 and PtdIns(3,4)P2 in the inner leaflet of the plasma membrane. These two lipids then co-ordinate the regulation of multiple protein targets by binding, with ...

Testosterone deficiency syndrome (TDS) may well contribute to a number of co morbidities and multitude of symptoms which may affect one’s daily activities adversely. TDS prevalence in UK is 1:500 and certain groups of patient’s are at higher risk of TDS, in particular elderly and patients with diabetes mellitus where 42% are known to have TDS. A retrospective audit was carried out to bench mark our practice in line with a publication of a recommended National/Europea...

The aim of these two case reports (husband and wife) is to highlight the importance of homeopathic medication on HPA axis.The first case is a 60-year-old Indian lady known to have diabetes mellitus, hypertension and hypercholesterolaemia, who presented with difficulty in losing weight and generalised aches and pains. As part of the investigations by her General Practitioner her serum cortisol was found to be low at 32 mmol/l. Short synacthen test showed ...

This is an unusual case of sleep apnoea treated with C-PAP as a result of multinodular goitre (MNG) which was overlooked.This is a case of a 69-year-old gentleman who was referred to the endocrine clinic for assessment of his diabetes. Sleep apnoea was diagnosed around four years ago and he has been using C-PAP every night. Enlargement of multinodular goitre coincided with the diagnosis of sleep apnoea. He has previously been seen by another endocrinolog...

It is paramount to educate our patients, thereby empowering them to manage their chronic conditions. This is an evidence based fact. As healthcare professionals our challenge is to provide and ensure patients have been well informed in order to understand and manage their condition successfully on a daily basis.In today’s healthcare service patient education has become a casualty of the reduced resources; there are ever increasing restrictions on bo...

We report three patients who were referred for possible chronic fatigue syndrome and presented with a long standing history of a multitude of symptoms. Comprehensive investigations revealed a low IGF1 and subsequent insulin tolerance test (ITT) demonstrated growth-hormone (GH) deficiency with a normal MRI pituitary in each case. The first patient presented at the age of 34 years with lethargy, aches and difficulty concentrating. Biochemically the only abnormality in th]e basal...

We report a case of a female patient who presented aged 37yr with tiredness, weight gain and oligomenorrhea. Biochemically she was diagnosed with primary hypothyroidism with a TSH 10.9 mu/L and free-T4 8.2 pmol/L (10.5–22.0); she was commenced onto Thyroxine 50 mcg once a day (OD). Six months later her thyroid function tests improved with a TSH 2.2 mu/L and free-T4 13.0 pmol/L, however she felt her symptoms had worsened. The dose of thyroxine was increased to 75 mcg OD. ...