Endocrine Abstracts

Thyroid nodule is a potential thyroid cancer and hence prompt assessment of all cases is mandatory. Fine needle aspiration (FNA) is a simple and reliable test in the management of thyroid nodule.This is a prospective audit of all new patients with thyroid nodules referred to our endocrine unit in the period between November 2000 to March 2002. 64 patients were identified, 57(89%) of which were females. The mean average age was 49. Thyroid function test w...

Introduction: It is known that certain endocrine disorders are related to each other and occur together due to their autoimmune aetiology. Patients with an autoimmune disease must be considered at risk for other autoimmune disease. Addison’s disease usually presents with recurrent hypoglycaemia in subjects with type 1 diabetes mellitus.We present a case Addison’s disease in type 1 diabetes presenting with severe hyperglycaemia.<p class="abs...

Introduction: Cushing’s syndrome is characterised by glucocorticoid excess. This is more commonly caused by excess adrenocorticotropic hormone (ACTH) produced either by a pituitary tumour (Cushing’s disease) or ectopic secretion. An example of the latter is the production of ACTH by a lung carcinoma (typically small cell)1. Other causes of Cushing’s syndrome include long term steroids or adrenal carcinoma.Case history: A 62-year...

Introduction: The biochemical diagnosis of hypophosphataemic rickets relies on measurement of tubular phosphate reabsorption. However, as the renal tubules are immature at birth and the reference range for urine phosphate excretion is not well defined in young children, there is uncertainty about how early in life a biochemical diagnosis of phosphate wasting can be made. In addition, the benefit of early treatment of hypophosphataemic rickets is unclear.<p class="ab...

Clinical case: A 37 year-old Caucasian man was admitted with sudden onset lower limb weakness following a carbohydrate-heavy meal the night before. Pulse was 110/min, sinus rhythm, BP 167/92 mmHg. There was generalised muscle weakness, particularly in his legs, with hyporeflexia and hypotonia. There was no sensory deficit and plantar responses were downgoing. Serum K+ was 2.4 mmol/L, associated with typical ECG anomalies, and was corrected with 40 mmol intravenous KCl followed...

Fine needle aspiration biopsy (FNAB) is the investigation of choice for patients with thyroid nodules in secondary care. Ideally the following standards should be met: assessment within 2 weeks of referral; FNAB performed in the first visit; consent obtained and documented; communication of the result in person.A cohort of 64consecutive patients (57 female) was identified. The median age was 49 (16-78). Thyroid function tests were normal in 89% of patien...

Fine needle aspiration biopsy (FNAB) is the investigation of choice for patients with thyroid nodules in secondary care. Ideally the following standards should be met: assessment within 2 weeks of referral; FNAB performed in the first visit; consent obtained and documented; communication of the result in person.A cohort of 64consecutive patients (57 female) was identified. The median age was 49 (16-78). Thyroid function tests were normal in 89% of patien...

Paragangliomas are rare tumours that arise from extra-adrenal chromaffin cells within the sympathetic paraganglionic axis. While neoplasms of the adrenal medulla, (phaeochromocytomas) are normally characterized by catecholamine (CA) hypersecretion, paragangliomas can be nonfunctional. We report our findings from 5 patients (4 males, 1 female) with paragangliomas. In 4 out of 5 patients the initial presentation was related to the space-occupying effect of the tumour. Episodic s...

Background: Autoimmune thyroid disease is a common cause of thyroid dysfunction, either Graves’ disease causing hyperthyroidism or Hashimoto’s thyroiditis causing hypothyroidism. It has been noted that patients suffering from autoimmune hypothyroidism can transform to hyperthyroidism and vice versa. We report the case of a patient with long standing autoimmune hypothyroidism presenting with active thyroid eye disease and subsequently diagnosed with Graves’ disea...

Clinical case: A 30-year-old Eritrean presented as an emergency to the orthopaedics surgeons with radicular back pain. Following L3/L4 spinal decompression, he was noted to be classically acromegaloid and was transferred to the Endocrine Unit, where a mild bitemporal upper quadrantinopia was noted. GH was massively elevated at 1200 mU/L, IGF1>130 nmol/L, with associated corticotroph and gonadotroph insufficiencies requiring replacement. MRI showed a large pituitary adenoma...