Endocrine Abstracts

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 ...

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 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. ...

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 5:1000 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/Europe...

In the National Health Service (UK), there are ever increasing demands to streamline care and develop patient pathways and guidelines as justification for any test or procedure. This is to ensure optimisation in patient care and experience.The role of a specialist nurse focuses on ensuring appropriateness and swiftness of investigations, including providing a high level of clinical care which has its foundations on communication and education for the pat...

Case: A 46-years-old anaesthetist presented with 2 weeks history of general malaise, sore throat, and fever. Symptoms started while on holiday. A diagnosis of subacute thyroiditis was made overseas based on presentation and suppressed TSH level. He was started on betamethasone 4mg and ibuprofen for 2 weeks with rapid symptomatic improvement. He felt well enough to travel back to UK. He then presented to our hospital with recurrent symptoms as above.Inves...

Insulinomas are rare neuroendocrine tumours that classically present with a combination of symptomatic hypoglycaemia, low serum glucose values and resolution of symptoms post glucose ingestion.We describe a 65-year-old lady who repeatedly presented over several years with recurrent infections, predominantly of the urinary tract, nausea and diarrhoea, necessitating frequent hospital admissions. Despite extensive investigations, no clear cause for her symp...

We report a case of a 27 yr female patient who initially presented with jaundice at 38 weeks gestation, with biochemical transaminitis. She had a caesarean section which was complicated postoperatively by hypotension due to haemorrhage requiring 20 units of blood/blood-products. A specialist liver unit felt the jaundice was secondary to fatty liver of pregnancy. She had difficulty breastfeeding and 18 months post partum she still had secondary amenorrhea so was commenced onto ...

A 68 year old gentleman referred to endocrinology clinic with a few years history of erectile dysfunction (ED), which manifested as reduced libido and partial erections. Investigations revealed primary hypogonadism with a low morning serum Testosterone of 4.8 (Ref: 7.9-31 nmol/l), raised FSH at 47 (Ref:1.5-12.4 iu/l) LH at 36.8 (Ref: 1.7-8.6iu/l) and normal thyroid function tests (TFTs). The patient declined testosterone replacement therapy following a discussion of pros and c...

Introduction: Hypothyroidism can present in a variety of ways, from unexpected abnormal blood results in seemingly asymptomatic patients to those with a multitude of debilitating symptoms. Levothyroxine dose titration is a challenge often faced by physicians. We identified 8 difficult cases which following MDT discussion underwent the Thyroxine Absorption Test (TAT) to gain further clarification (Walker et al. 2013).Aim: To identify if the issue...