Endocrine Abstracts

Opioids –Yet another Cause for Adrenal Insufficiency. Opioid prescriptions have almost doubled in the last decade in the UK. Opioid related hypogonadotropic hypogonadism is a well-recognised clinical entity. Opioid therapy as a cause of adrenal insufficiency is an under-recognised endocrinopathy with potentially lifethreatening adverse effects. We present the case of a 57 year old lady referred to the endocrine clinic with symptoms of generalised fatigue and weakness. Her...

We present two patients with significant hypokalaemia initially attributed to liquorice use.Case 1: A 52-year-old engineer was noted to have a potassium level of 2.5 mmol/l (3.5–5.3 mmol/l) at a Well Man check-up. He had no significant past history, and took no medications. He was normotensive. The patient reported regular liquorice use. The hypokalaemia corrected with supplementation equivalent to 48 mmol K+ daily, and with cessation of ...

A 56 year old lady was investigated by her GP for arthralgia and found to be thyrotoxic (TSH < 0.01 mU/l, free T4 34.8 (10–20 pmol/l), TPO 50 (<35 IU/ml)). She gave a history of anterior uveitis some 20 years earlier. She was commenced on carbimazole and referred to the endocrinology clinic, where her thyroid function rapidly normalised and a biochemical diagnosis of subacute thyroiditis was made. Thyroid pertechnatate scan showed reduced uptake throughout the gl...

An 85-year-old woman attended the endocrine clinic with hypercalcaemia and raised PTH levels. Her background included breast cancer treated with bilateral mastectomy and hormone therapy 3 years previously, with no evidence of disease on imaging 2 years previously. On attendance, her clinical examination was unremarkable, with no palpable neck mass. Biochemical investigations showed: Adj Ca 3.12 mmol/l, PTH 45.0 pmol/l, PO4 0.94 mmol/l, ALP 119U/l, Alb 45g/l, 25-OH Vit D 15.7 n...