Endocrine Abstracts

Acute deterioration in Graves Opthalmopathy (GO) has infrequently been described following total thyroidectomy. A 56 year old female smoker presented in January 2010. Thyroid function tests: TSH<0.01, free T4 (fT4) 47. Thyroid receptor antibody (TRAb) was raised at 31 (<1.5). She was commenced on carbimazole treatment. She had no GO at time of diagnosis. She discontinued carbimazole due to rash. She represented in December 2010 with symptoms of thyrotoxicosis. TSH<...

Familial hypocalciuric hypercalcaemia (FHH) is an inherited disorder of calcium homeostasis, which is caused by germline loss-of-function mutations of the calcium-sensing receptor (CaSR) in ˜70% of cases. We report a 22 year old woman who was referred with asymptomatic hypercalcaemia. Biochemical investigations revealed hypercalcaemia on 3 of 4 occasions with adjusted serum calcium ranging from 2.59–2.80 mmol/l (normal range 2.20–2.60 mmol/l). Parathyroid hormon...

Carney’s triad; a diagnosis based on the presence of three associated neoplasms; epithelioid leiomyosarcoma, pulmonary chondroma, and extra-adrenal paraganglioma remains a rare diagnosis. Here we report a 52-year-old female investigated for chronic cough. Initial chest X-ray demonstrated calcified masses, and CT thorax confirmed a left pulmonary lesion measuring 41 mm in diameter with 3 adjacent smaller nodules up to 20 mm. A chondroid pattern o...

We present the case of a 51-year-old woman who attends the NET service at the Oxford University Hospitals Trust with multiple known secretory paragangliomas (predominantly 3-methoxythyramine), including a carotid body tumour and, most recently, an intrapericardial paraganglioma. She is SDHC mutation positive. Multiple surgical resections of paragangliomas, at sites other than the cardiac lesion, had previously been undertaken. Due to disease progression and symptomati...

The Endocrine Society Guidelines 2016 recommend the Aldosterone Renin Ratio (ARR) to screen for Primary Hyperaldosteronism (PHA), yet we perceive low rates of referral to our service for such patients. Here we report a retrospective audit of ARR measurements requested through Regional Hospital Mullingar 01/01/2023 – 31/12/2023. ARR results were obtained directly from the referral laboratory. An assay specific ARR threshold >25 (ARR+) indicates possible PHA. We reviewe...

Thyroid Orbitopathy is rarely associated with de novo Primary Hypothyroidism; this phenomenon is incompletely understood. Here we present the case of a 51-year-old female presenting with Primary Hypothyroidism, Thyroid Orbitopathy, and high titres of Anti-TSH Receptor Antibodies (TRAb), and discuss the potential underlying pathogenesis. Our patient first presented to Regional Hospital Mullingar with an unrelated, and ultimately self-limiting, complaint. The Endocrinol...

Case history: A 38-year-old woman presented with blepharospasm, cramping of the hands, and paraesthesia primarily affecting the face and hands. Symptoms had been present for 10 years but had been progressive over the previous 12 months. Symptoms were consistent with neuromuscular instability. Hypocalcaemia and elevated Parathyroid hormone (PTH) were confirmed. Past medical history was notable for anorexia nervosa in remission. Family history was non-contributary. Hypocalcaemia...

We present the case of a 54-year-old woman with known metastatic non-functional pancreatic NET since 2004 that developed new debilitating recurrent hypoglycemia in 2013. The patient presented in 2004 with disseminated malignancy. Radiology revealed a large pancreatic mass associated with multiple liver lesions and abdominal lymphadenopathy. Liver biopsy confirmed well differentiated NET. Initial treatment with cisplatin etoposide chemotherapy was poorly tolerated and discontin...

Primary hyperparathyroidism (PHP), usually due to multigland hyperplasia, occurs in >90% of patients with multiple endocrine neoplasia type 1 (MEN1). The literature is divided on the optimal surgical management for such patients. We report a retrospective cohort study on the long-term outcomes associated with limited, subtotal, or total parathyroidectomy as initial surgery for PHP in MEN1. The primary endpoint was recurrent PHP defined as an adjusted serum calcium >2.6 mmol/l ...

Endocrine Society guidelines recommend random growth hormone (RGH) <1 mcg/l as indicative of biochemical control of acromegaly. Growth hormone (GH) control may also be determined using the mean GH (MGH) of a growth hormone day curve (GHDC). We report a retrospective analysis of 461 consecutive GHDCs, from 121 patients with treated acromegaly, performed in a single centre between 2009 and 2019. Each GHDC contained 7–9 GH measurements (mean 8.9) taken at regular interva...