Endocrine Abstracts

An association between the use of proton pump inhibitors (PPIs) and profound hypomagnesaemia has been highlighted in a number of case reports. As the prevalence of this occurrence or cause remain unknown, we undertook a review of patients with significant hypomagnesaemia in our hospital with a particular focus on use of PPIs and management.35 patients (21f; mean age (S.D.): 71.3 (14.6); median: 74 years) with significant hypomagnesaemia (d...

A 68 yr old male with a history of type 2 diabetes presented with myalgia and girdle weakness affecting him on a frequent but episodic basis. Investigations confirmed Cyclical Cushing's Disease. Pituitary MRI was normal. Further investigations include bilateral inferior petrosal sinus sampling (BIPSS) which can help determine the origin of ACTH-dependent Cushing’s syndrome. After CRH-stimulation, a peak central to peripheral ACTH ratio of >3 suggests a pituitary ACTH ...

A 28-year-old man presented to his GP in Turkey complaining of fatigue. As part of his work up, serum PTH was assessed and was found to be markedly elevated at 29.9 pmol/l (normal range 1.6–6.8), with normal calcium, phosphate, alkaline phosphatase, renal function, 1,25- and 25-hydroxy vitamin D3 levels. A DEXA scan was normal and a Sestamibi scan did not reveal any parathyroid adenoma. Prior to any further investigations or treatment, he moved to the UK.<p class="abs...

We report a case of a false positive pentagastrin stimulation test in a patient with a positive family history for medullary thyroid cancer (MTC), but normal histology following total thyroidectomy.An asymptomatic 50-year-old man was referred urgently with an elevated calcitonin level of 19.9 ng/l (reference range<11.8), taken following the diagnosis of his brother with MTC which had been discovered on a routine private medical examination. There was...

Case report: A 67-year-old female with untreated congenital adrenal hyperplasia (21-hydoxylase deficiency) was diagnosed with bilateral vulval carcinomata. She was referred to another unit with serum sodium of 121 mmol/l, potassium 4.6 mmol/l and 17-hydroxyprogesterone of 714 nmol/l (0–14 nmol/l). A short synacthen test performed in the evening demonstrated a baseline cortisol of 558 nmol/l, rising to 643 nmol/l at 80 min. The baseline cortisol was deemed adequate but in ...

Serum parathyroid hormone (PTH) and other parameters are measured post-parathyroidectomy to assess cure. A persistently raised serum PTH may indicate an unsuccessful procedure. However, vitamin D deficiency is increasingly recognised in the general population, and may be a cause of raised PTH post-surgery (secondary hyperparathyroidism). Persistently elevated post-operative PTH may continue to stimulate bone turn over and bone loss post-surgery. Our aim was to determine whethe...

Objective: The British Thyroid Association (BTA) published guidelines for thyroid function testing (TFTs) in June 2006, recommending that TFTs should not be requested for acute medical patients in the absence of specific clinical indications. This audit assesses the proportion of thyroid function tests performed on acute medical inpatients that are indicated.Design: Retrospective data collection on 205 sequential thyroid function tests performed over 3 m...

Introduction: A persistently elevated parathyroid hormone (PTH) following parathyroidectomy is usually associated with vitamin D deficiency. We have previously demonstrated this to occur in ~60% of post-operative patients. We have examined the effect of routine vitamin D replacement pre-operatively on the proportion of patients with persistently elevated PTH post-operatively.Methods: Data was collated retrospectively from our parathyroid database, includ...