Endocrine Abstracts

Background: We previously reported that a high number of synacthen tests are carried inaccurately within our trust with a significant delay in sample collection after tetracosactide injection. We also reported a high number of patients having Synacthen tests unnecessarily. In light of this we introduced a Synacthen proforma and re-audited our results.Method: A retrospective study was carried out on 36 patients undergoing Synacthen tests bet...

Background: We previously reported that a high number of synacthen tests are carried inaccurately within our trust with a significant delay in sample collection after tetracosactide injection. We also reported a high number of patients having Synacthen tests unnecessarily. In light of this we introduced a Synacthen proforma and re-audited our results.Method: A retrospective study was carried out on 36 patients undergoing Synacthen tests bet...

A 21 year old Caucasian female with no known personal or family history of thyroid disease presented with several years history of anxiety and was found to have abnormal thyroid function tests. Results showed TSH: 1.8 mu/l (0.3–5.5), T4: 73 pmol/l (10–22), T3 12.3 pmol/l (3.1–6.8). Past medical history included chronic anxiety with no regular medications or nutritional supplements. There was no history of recent iodinated contrast administr...

Phaeochromocytomas show a positive correlation between tumour size, metanephrines level and symptoms. Small tumours (<1 cm) are usually asymptomatic and are picked up through hereditary screening or surveillance of previous tumours. We present a 72-year-old gentleman who was referred to the Endocrinology service with symptoms of palpitations, sweating, dizziness and hypertension for several years. He was investigated for palpitations but no cardiac arrhythmias were present...

Langerhans Cell Histiocytosis is an inflammatory myeloid neoplasia caused by mutations of several genes in the MAPKinase (MAPK) pathway which can present in single or multiple sites. Our patient presented to her GP with several months of amenorrhoea, thirst, tiredness and 3 stone weight loss. She was previously fit and well, working, and married with children. Blood tests revealed panhypopituitarism with low 9am cortisol 117 nmol/l (133-537). Oestrogen and gonadotrophins were ...

Anabolic androgenic steroids (AAS) are class C drugs with adverse effects on health. Prevalence is increasing, often with a lack of awareness of the dangers. We present the case of a 33 year-old male with dilated cardiomyopathy and polycythaemia apparently due to AAS abuse over three years. The patient presented with five weeks of increasing breathlessness and chest tightness. Examination revealed evidence of congestive cardiac failure. Chest radiograph showed evidence of pulm...

A frail, long-term surgical inpatient, was under-nourished on TPN. He had a tendency towards hypocalcaemia and was under regular review by the surgical and nutrition team. It was noted on his routine monitoring that his Ca had fallen to 1.78 mmol/l (2.2-2.6 mmol/l). He was reviewed out-of-hours and prescribed 10mls of 10% Calcium Gluconate infused over 10 minutes, as per the hospital guidance for the treatment of hypocalcaemia. A further prescription of calcium gluconate 10% i...

Background and aims: Patients with Graves’ disease should be rendered euthyroid rapidly and euthyroidism subsequently maintained. Studies have shown this can be achieved at 3 months and maintained for the following 9 months in 90% of patients. The aim of this review was to ascertain whether we were achieving this target within our hospital setting.Method: We undertook a retrospective analysis of patients with Graves’ thyrotoxicosis referred to ...

Background: Short Synacthen tests (SSTs) are used to assess adrenal function by injecting tetracosactide and measuring blood cortisol after 30 and 60 min. Many SSTs at Royal Bournemouth Hospital (RBH) are undertaken externally to the Bournemouth Diabetes and Endocrine Centre (BDEC). There is an increasing cost-implication for undertaking SSTs exacerbated by recent problems with Synacthen supply. A 0900 h cortisol or random cortisol on acutely unwell patients can be sufficient ...

Background: Short Synacthen tests (SSTs) are used to assess adrenal function by injecting tetracosactide and measuring blood cortisol after 30 and 60 min. Accuracy of timing helps enable successful interpretation of results. A SST is an invasive test although it is normally well tolerated. There is an increasing cost-implication for undertaking SSTs exacerbated by recent problems with Synacthen supply.Method: We undertook a retrospective audit of 333 pat...