Endocrine Abstracts

This 60-year-old male was reviewed remotely for follow up in the general endocrine outpatient clinic having originally been referred for erectile dysfunction and low libido. He had a past medical history of hypertension and dyslipidaemia and was prescribed amlodipine and atorvastatin. On previous clinical assessments, he had increased muscle bulk, normal secondary sexual characteristics with testes measuring 15mls and 12mls. There had been no evidence of gynaecomastia. He work...

Primary hyperparathyroidism is rarely diagnosed in pregnancy; not only because it is uncommon in that age group but also because many of the symptoms overlap with non-specific pregnancy symptoms (nausea, vomiting, fatigue, constipation). Primary hyperparathyroidism with significant hypercalcaemia can potentially cause serious maternal (preeclampsia, nephrolithiasis, pancreatitis and hypercalcaemic crisis) and foetal (miscarriage, stillbirth, neonatal hypocalcaemia leading to t...

Introduction: Gestational transient thyrotoxicosis (GTT) affects 2–3% or pregnancies of European women and 11% of pregnancies of Asian women and typically resolves within the 2nd trimester. GTT rarely manifests with the typical symptoms of thyrotoxicosis and instead is associated with hyperemesis gravidarum. GTT can be confused with thyrotoxicosis occurring in pregnancy which requires prompt treatment with antithyroid drugs (ATDs) to minimise maternal and foetal risk. Inj...

Introduction: Primary hypothyroidism is most commonly caused by autoimmune hypothyroidism whilst additional causes include post radioactive iodine treatment (RAI) whereas central hypothyroidism is typically associated with pituitary disease. Treatment in primary hypothyroidism aims to maintain the TSH within the reference range whilst treatment of central hypothyroidism is aimed at maintaining free T4 in the upper half of the reference range as established by intern...

Case history: A 46-year-old female patient presented to A&E with a three day history of diarrhoea and vomiting, after three months of progressive weight loss. Her past medical history included chronic autoimmune thrombocytopaenia and Graves’ disease, which had been diagnosed four years earlier and treated with a brief course of propylthyuracil (PTU). She was clinically in extremis, with signs of severe cardiovascular and respiratory compromise and reduced res...

Hyperprolactinaemia is the most common endocrine disorder of the hypothalamic-pituitary axis and represents a significant referral volume to secondary care. It is therefore necessary to employ a timely, structured management pathway.This retrospective cohort study at University Hospitals Birmingham, included 450 patients with serum hyperprolactinaemia, measured between 2011 and 2012. Patients with a known hyperprolactinaemia were excluded. 71 patients re...

Background: Confirming a genetic diagnosis earlier in patient pathways has multiple benefits: it informs and directs clinical management, enables patients to access support organisations, and helps patients adjust to their lifelong condition. This audit assessed the appropriate usage of genetic testing within Endocrinology at Birmingham Heartlands Hospital (BHH). The key three outcomes investigated were whether genetic testing was being appropriately ordered; ...

Introduction: Transsphenoidal pituitary surgery (TSPS) may be required either as a treatment for endocrinopathies or because of the risk or consequence of pituitary lesion expansion into adjacent structures, in particular optic chiasm compression. Published literature recommends surgery is performed by dedicated experienced surgeons with anticipated complication rates available as a comparator.Methods: This retrospective audit included all patients diagn...

Introduction: Obstructive sleep apnea (OSA) affects up to 20% of a Western population and is associated with non-alcoholic fatty liver disease and type 2 diabetes (T2D). OSA is characterized by intermittent episodes of hypoxia (IH) that occur during sleep. It is not yet known if IH is directly linked to insulin resistance within key metabolic target tissues (adipose; liver and skeletal muscle) and what the potential underlying mechanism may be. It has been suggested that indiv...

Objectives: To report outcomes comparing RYGB (Roux-en-Y gastric bypass) and OAGB (one anastomosis gastric bypass) on patients with obesity. To further investigate the efficacy of OAGB, given that there is significant interest in OAGB as it has reported reduced operating time, better weight loss and increased remission of obesity-related comorbidities. However, there are concerns over potentially serious postoperative complications causing limited uptake.<p class="abstext"...