Endocrine Abstracts

We report the cases of two identical twins with Graves’ disease which proved very difficult to control and followed very similar stormy course. Twin A was a 20 years old female of 12 weeks gestation when she was referred to endocrine clinic with history of weight loss, palpitations and tremor. Her thyroid function tests revealed TSH <0.08 mU/L (0.03–4.30), FT4 82.5 pmol/L (12–22 pmol/L) and FT3 44.4 pmol/L (2.8–7.1) with positive thyroid receptor ant...

We report the case of a 27 year old female who was referred to our diabetes team from the antenatal clinic, when she was found to have an abnormal glucose tolerance at 16 weeks of gestation (fasting and 2 hours blood glucose values of 5.1 mmol/L and 12.2 mmol/L respectively). At the same time she was suffering with severe hyperemesis gravidarum for many weeks and had suffered significant weight loss (thyroid function tests were unremarkable). She had no specific symptoms to su...

We report the case of a 22-year old woman with aggressive Graves disease. She was initially found to be clinically and biochemically thyrotoxic in June-2001 when she presented with severe thyroid eye disease. Treatment was commenced with carbimazole but she failed to adequately comply with therapy and follow-up appointments. She fell pregnant whilst thyrotoxic and was converted to propylthiouracil (dose gradually increased due to poor response). She then left the area and had ...

We report two cases of seizures resulting from severe electrolyte imbalance.Case 1: A 48-year old lady with CREST syndrome and oesophageal dysmotility. She was admitted with diarrhoea and vomiting. Routine investigations including FBC, U&E, LFT, and CRP were normal. She later complained of pins and needles in her hands and around her mouth. Twenty-four hours later, she developed blurred vision, neck pain and generalised ache, was found drowsy, with p...

Introduction: We present 3 cases of the same severe electrolyte imbalance presenting with acute neurological symptoms.Case descriptions: Case A, a 48 year old lady with severe CREST syndrome presented with prolonged vomiting and diarrhoea. Initial investigations showed: Sodium 141 mmol/l, Potassium 3.2 mmol/l, Creatinine 53 mmol/l, Glucose 4.3 mmol/l, Haemoglobin 13.9 g/dl, Albumin 38 g/l. 2 days after admission she developed seizures. Case B, a 75 year ...

We report the case of a 70 year-old-lady with a background of type 2 diabetes and hypertension who was admitted with a history of self-neglect. She had burns affecting her hands which she had sustained after falling asleep next to the fire five weeks previously. Over the preceding three months, the patient had also deteriorated in terms of self-care, appetite, mobility and control of her blood sugars.On examination, the patient was noted to have severe u...

We present an unusual cause for symptomatic hypopituatism presenting due to a metastatic deposit. A 77 year old smoker and ex-miner was admitted with a 3 week history of breathlessness, malaise and weight loss. He had clinical evidence of a severe pneumonia but also had clubbing, was hypotensive, hypothermic and hypoglycaemic. He had no clinical features of Addison’s disease, no neurological symptoms or signs and a normal breast examination. Chest X-ray suggested extensiv...

We report the case of a 42-year-old transsexual with Di-George syndrome (DGS) presenting in adulthood with profound hypocalcaemia and personality disorder. The patient had multiple hospital admissions with episodes of deliberate self-harm and recurrent seizures. Routine investigations revealed hypocalcaemia secondary to hypoparathyroidism. The diagnosis of DGS was delayed until six years later. The clue to the underlying condition was the finding of DGS in the patient’s d...

We present 2 cases of extraadrenal phaeochromocytoma with several unusual features: (a) A 54 year-old female presented with dizziness, falls, and palpitations. She was tachycardic with blood pressure of 218/75 supine and 139/107 standing. An abdominal mass was palpable. Urinary catecholamines were markedly raised and a CT scan showed para-aortic mass with avid MIBG uptake confirming the diagnosis of an extraadrenal phaeochromocytoma. Persistent hypokalaemia and hyperglycaemia ...

BackgroundInappropriate footwear is a major cause of ulceration in diabetes while good footwear prevents ulceration and recurrence.AimTo analyse the benefits of orthotic interventions in foot ulcers in our high risk diabetic patients.Design and methodsWe present preliminary data of a prospective analysis of 18 diabetic patients from our foot clinic to evaluate res...