Endocrine Abstracts

We report a case of a 57-year-old woman with profound uncontrolled hypothyroidism diagnosed in 1999. At her first Endocrine clinic visit in 2015, her TSH level was 93.4 mU/l with FT4 level of 4.8 pmo/l. Despite increasing her Levothyroxine dose, her TSH level remained persistently above 80 mU/l with a low FT4. She had a gastroscopy and coeliac screening which were non-significant. Triiodothyronine 10 mg was added to Levothyroxine 100 mg once daily in October 2015. However, she...

A 54-year-old gentleman presented to his GP in July 2019 with significant weight loss, polyuria and nocturia for two to three months. His HbA1c was 78 mmol/mol. He was diagnosed with diabetes and started on Metformin 500 mg BD. Upon consultant review in September 2019, he reported a 26 kg weight loss over the preceding four years, much of which was apparently intentional, and right abdominal discomfort. His paternal grandmother died of pancreatic cancer, as did his paternal au...

A 74-year- old gentleman was found to be hyponatraemic when he returned from birds watch trip with cellulitis of lower legs. He was generally fit and well apart from hypertension for which he had been on Amlodipine and Irbesartan. He was admitted with severe hyponatremia in July 2019 and was diagnosed with idiopathic SIADH as evidence of low serum osmolality (252 mosm/kg), high urine sodium (41mmol/l) and high urine osmolality (657mmol/kg). His Amlodipine and Irbesartan were r...

We report a case of 39-year-old woman presenting with sudden severe abdominal pain and vomiting. She had a past medical history of anti-phospholipid antibody syndrome (APLS) diagnosed in the United States (US) 20 years ago. She had multiple episodes of vomiting over the last 10 years and was diagnosed with cyclical vomiting as investigations including CT abdomen and endoscopy did not reveal a structural cause. She was taking warfarin for APLS. She was haemodynamically stable a...

We report a case of 39-year-old woman presenting with sudden severe abdominal pain and vomiting. She had a past medical history of anti-phospholipid antibody syndrome (APLS) diagnosed in the United States (US) 20 years ago. She had multiple episodes of vomiting over the last 10 years and was diagnosed with cyclical vomiting as investigations including CT abdomen and endoscopy did not reveal a structural cause. She was taking warfarin for APLS. She was haemodynamically stable a...

A 47-year-old Caucasian gentleman was diagnosed with diabetes mellitus in September 2019. He presented with blood glucose 29.5 mmol/l and negative ketones in December 2020 and was treated with variable rate insulin infusion. He had short stature with height of 161 cm and weight 53.5 kg (BMI 20). There was mild weakness of quadriceps (4/5). Laboratory tests revealed high lactate (5.38 mmol/l) and HBA1c (70 mmol/mol), reduced eGFR (47 ml/min) and negative antibody. He had gradua...

Case history: A 38 years old Afro-Caribbean gentleman presented in June 2018 with symptoms of hyperthyroidism. He is a smoker and takes alcohol occasionally. Examination revealed fine tremors, tachycardia, moderate sized goitre with no thyroid bruit and right sided proptosis. Thyroid workup revealed suppressed TSH, raised free T4 and TRAb of 9.75 IU/L suggesting Graves’ Thyrotoxicosis. He was started on 20 mg of Carbimazole (CBZ)OD with Propanolol. After initiating carbim...

Case History: 38 year old male presented with thyrotoxic symptoms and exophthalmos with an initial Free T4 of > 100 pmol/l; TSH < 0.01 mIU/l and thyroid receptor antibody positivity. He had a platelet count of 72* 109 /L at presentation and was started on carbimazole. A month later he had platelet count of 9* 109 /L with normal white cell count and haemoglobin levels. He was switched to propylthiouracil, but was readmitted with platelet count of 1...

Sarcoidosis is a granulomatous multi-systemdisorder of unknown ethology. It has a higher prevalence in Northern Europe and the UK. Neurosarcoidosis is a relatively less common, but serious complication of sarcoidosis. CASE: A 48 year old man presented to the hospital with intermittent fever, and neck pain and stiffness, of six weeksduration. This was associated with excessive tiredness, loss of libido, decreased appetite, and unintentional weight loss of two stone over a perio...

Background: Clinically relevant pituitary adenomas (Pit PA) affect approximately 1:1200 of the general population, and may manifest with hormone hypersecretion, hypopituitarism and compression of the visual pathways. Primary aldosteronism (Adr PA) is now recognised to account for 5–14% of all cases of hypertension and is associated with excess morbidity when compared with primary hypertension. Here, we report a patient who was noted to have a history suggestive of Adr PA ...