Endocrine Abstracts

Clinical Case: A 51 year old woman of south Asian descent was referred by her GP to outpatient endocrine clinic for assistance with her mixed hyperlipidaemia (Cholesterol 9.5 mmol/L, HDL Cholesterol 1.03 mmol/L Triglycerides 6.7 mmol/L). Her past medical history included a previous hemithyroidectomy for removal of a thyroid nodule (histologically benign) and obesity.The patient’s symptoms were of weight gain (5 kg in 18 months...

Clinical Case: A 51 year old woman of south Asian descent was referred by her GP to outpatient endocrine clinic for assistance with her mixed hyperlipidaemia (Cholesterol 9.5 mmol/L, HDL Cholesterol 1.03 mmol/L Triglycerides 6.7 mmol/L). Her past medical history included a previous hemithyroidectomy for removal of a thyroid nodule (histologically benign) and obesity.The patient’s symptoms were of weight gain (5 kg in 18 months...

Introduction Carcinoid heart disease most frequently involves the tricuspid or, more rarely, the pulmonary valve and presents with right heart failure as 5-HT is metabolized by the lung. Left-sided valve involvement is quite rare. We describe our experience of 3 patients presenting with heart failure secondary to carcinoid heart disease affecting all four cardiac valves. There are only four previous isolated case reports in the literature. Methods All th...

A 34-year old lady presented in the postpartum period following her 3rd pregnancy with severe hypertension. Her first two pregnancies were 3 and 5 years previously where she delivered via elective Caesarean section without any complications. During this pregnancy which was a twin pregnancy, her antenatal care was mainly unremarkable but on specific questioning, she reported increased sweating for a period of 4 months. Her blood pressure was noted to be normal during her antena...

Introduction: Hormone-secreting teratomas are well described. However teratomas secreting pancreatic hormones are rare, with even fewer cases producing clinically significant effects. We describe possibly the first documented case of hyperinsulinaemic hypoglycaemia due to an insulin-secreting ovarian teratoma.Case report: A 23-year-old woman presented with transient symptoms of lethargy and weakness. She had used her father’s capillary glucose meter...

Case history: We present the case of a 40-year-old man who was referred to a cardiologist with hypertension. He was initiated on bisoprolol and doxazosin. Investigations revealed elevated urinary metanephrines and catecholamines, with normetadrenaline 7.4 μmol/24 h (normal <2), noradrenaline 820 nmol/24 h (normal <500) but normal dopamine levels. He was referred to our clinic. Two further 24 h urine catecholamine assays were elevated. Dexamethasone suppression tes...

Introduction: Palpable thyroid nodules have a prevalence of 4–7%, which increases with imaging. About 5% are malignant. Efficient management is essential. USG and FNAC are valuable in assessing and preventing unnecessary thyroidectomies. Objective To compare our practice with local and Royal College of Pathologists guidelines. Methods All thyroid nodule patients seen in clinic between April to September 2010 were included. Data collected included age, gender, TFT, thyroid...

Malignancy-related hypercalcaemia occurs in over 20% of cancer patients. Most cases are due to enhanced production of parathyroid hormone-related peptide (PTHrP) by tumours and carry a poor prognosis of survival of weeks to months. A 74 year old man with a history of prostate cancer treated with radical radiotherapy in 2013 and androgen blockade until 2015 underwent CT and PET/CT scans in 2017, which showed liver and spleen abnormalities, suggestive of metastases, but unlikely...

Case History: 17 year old boy presented with a six week history of polyuria, polydipsia, headaches and easy fatiguability. Further investigations confirmed hypopituitarism with low early morning urine osmolality. MRI brain revealed soft tissue mass arising from tectal plate extending into cerebral aqueduct resulting in hydrocephalus with normal pituitary gland. Hydrocortisone, Levothyroxine and Desmopressin were started and urgent in-patient transfer to Neurosurgical unit in t...

Clinical Case: A 48-year old male presented with gradual onset of shortness of breath and atrial tachycardia requiring admission to intensive care unit. He was normally fit and well and did not have any history of thyroid/neck surgery. He was an ex-smoker who drank more than 40 units of alcohol per week.Investigations: Laboratory tests revealed low serum calcium of 1.03 mmol/l (2.15–2.6 mmol/l), high serum phosphate of 2.77 mmol/l (0.9–1.50 mmo...