Endocrine Abstracts

: Ectopic parathyroid adenomas have a low imaging incidence quoted at 1.4% in patients undergoing investigation for primary hyperparathyroidism with a prevalence of 6–30%. These are reported to have a more clinically severe manifestation of the disease, frequently with higher calcium levels and bone disease. Remission due to parathyroid infarction is a rare occurrence. We report a 54-yr Afro-Carribean/mixed race female who presented with lethargy, weight loss and reduced ...

: Ectopic parathyroid adenomas have a low imaging incidence quoted at 1.4% in patients undergoing investigation for primary hyperparathyroidism with a prevalence of 6–30%. These are reported to have a more clinically severe manifestation of the disease, frequently with higher calcium levels and bone disease. Remission due to parathyroid infarction is a rare occurrence. We report a 54-yr Afro-Carribean/mixed race female who presented with lethargy, weight loss and reduced ...

Case history: We report a 25-year-old man who presented to Neurology with two years history of a migrainous headache mainly at night. MRI head scan demonstrated large lobulated pituitary macroadenoma with significant suprasellar extension and anterior visual pathway compromise along with distortion of the basal forebrain, particularly on the right. Consequently, he was referred to the endocrinology team for further management. Upon initial assessment, he reported foot size enl...

We report a 42-year-old female who was known to have autoimmune hypothyroidism for nearly 20 years with positive antiTPO antibodies. She was well controlled on levothyroxine including three antenatal periods when she required a slightly higher dose of 125 mcg daily. No significant past medical history and denies use of herbal/over the counter medications. In early 2017, the patient started to experience nonspecific symptoms of lethargy and tiredness. Her thyroid state was mana...

Introduction: Carcinoid crisis represents a rare medical emergency with potentially fatal manifestations that can occur in patients with neuroendocrine tumours (NETs). The condition is caused by a substantial release of vasoactive metabolites from the NETs during diagnostic or therapeutic interventions. However, in rare instances, it can occur spontaneously. Here, we report a patient who developed a carcinoid crisis following radioactive iodine131I (RAI) treatment f...

We describe a 39-year-old lady who was managed as polycystic ovarian syndrome for nearly six years with an initial testosterone level of 5 nmol/l (0–1.8 nmol/l). She underwent laparoscopic ovarian drilling surgery followed by two unsuccessful IVF cycles for primary infertility. Deranged liver function and subsequent diagnosis of non-alcoholic fatty liver disease halted third trial of IVF. At that time, pelvic ultrasound demonstrated five follicles in both ovaries. In addi...

Case history: 63 year man with two trans-temporal incomplete resections of a glomus jugulare tumour (HNPGL) in 1993 and 2000 with regular surveillance scans for residual disease. Eight years later, an MRI demonstrated an incidental pituitary macroadenoma with cavernous and sphenoid sinuses invasion. The patient was asymptomatic but, his biochemistry revealed a markedly raised prolactin of 43,000 mIU/l with no other pituitary hormone deficiency. Cabergoline was commenced and th...

Introduction: Distinguishing arginine vasopressin deficiency (AVD) from primary polydipsia (PP) can be challenging in clinical practice. Copeptin is produced in equimolar amount to AV and is considered diagnostic biomarker to establish the diagnosis of AVD with and without provocative testing.Methods: Patients referred with polydipsia, hypotonic polyuria (>3L/day) and normonatraemia had overnight fasting plasma copep...

Background: Traditional method in Sheffield involved preoperative admission and use of an intensive regimen. The pandemic led to the development and implementation of an outpatient-based protocol (SPROG - ‘Sheffield Peri-operative Rapid Optimisation in Graves’ disease (GD)’) for patients’ intolerant to thionamides and/or with uncontrolled disease requiring thyroidectomy. Control was achieved using sequential addition and dose-escalation of drugs such as Lug...

We present the case of 78-year-old female admitted to our hospital in January 2023 with recurrent hypoglycaemic episodes during fasting periods, particularly overnight and early morning. The patient had impaired hypoglycaemia awareness and cognitive decline. The only past medical history was of hypertension treated with bendroflumethiazide and amlodipine. During hospital stay, she experienced multiple hypoglycaemic episodes. Biochemical investigations revealed non-insulin-depe...