Endocrine Abstracts

An 85 year old woman presented with generalised fatigue.Clinical examination was unremarkable but her biochemistry showed low sodium level of 112 millimoles per litre ( NR : 135-145 ).Investigations were suggestive of Syndrome of Inappropriate Antidiuretic Hormone Secretion ( SIADH ) with low serum osmolality , high urine osmolality and high urinary sodium .Further investigations were normal including renal function , short synacthen test , chest x-ray and CT scan of t...

An 85 year old lady was admitted with painless jaundice and cholestatic liver functions (LFTs). Investigations organised by gastroenterologists were fine including hepatitis viral screen, copper and ceruloplasmin levels, alpha -one antitrypsin, alpha -fetoprotein, immunoglobulins, auto-immune screen and ultrasound scan of the liver. In view of palpitations and weight loss, thyroid functions (TFTs) were done and showed biochemical hyperthyroidism: FT4 of 36.8 pmol/L (12–22...

Introduction: Amiodarone is a class III antiarrhythmic agent widely used in the treatment of atrial and ventricular arrhythmias.Amiodarone is known to cause thyroid dysfunction in three ways; amiodarone induced hypothyroidism, amiodarone induced thyrotoxicosis (AIT) type I and type II.We present a case of a patient with AIT type II who subsequently developed hypothyroidism.Case presentation: A 43-year-old man...

A 48-year-old gentleman was referred to the endocrine team with abnormal thyroid function tests (TFTs). His background history included cardiomyopathy complicated by atrial fibrillation (AF). He had been treated with amiodarone for a year. TFTs were monitored regularly during treatment and were normal. Four months after stopping amiodarone, he complained of weight loss, sweating and tremor. He had no family history of thyroid disease. He had a resting heart rate of 120/min (AF...

A 76 year old woman was referred in December 1997 to the Endocrine clinic at Luton & Dunstable Hospital following admission with atrial fibrillation which was managed by digoxin, flecainide and warfarin.Investigations initiated by her GP included reduced TSH at 0.18 milliUnits/Litre (0.32-5.00) despite normal free T4 of 14 picomols/Litre (9-24) and normal free T3 of 4.4 picomols/Litre (2.5-5.3). Ultrasound scan was in favour of multinodular goitre an...

Background: Hyperinsulinemic hypoglycaemia (HH) after Roux-en-Y gastric bypass (RYGB) is rare. Patients typically present with post-prandial hypoglycaemia >1 year after surgery and once weight loss has plateaued. Despite multiple treatment options, the management of these patients remains challenging.Clinical case: A 31-year-old female was referred for bariatric surgery with a BMI of 41.4 kg/m2. In the year preceding the r...