Endocrine Abstracts

Section 1: Case history: An 18 year old young man with a background of several years’ ADHD (Attention Deficit Hyperactivity Disorder) and moderate learning disability presented generally unwell, with recent weight loss, abdominal pain, vomiting and poor oral intake in May 2019. He had been unsettled for some time with his mother convinced that his current condition warranted further investigation. When blood tests were done, severe hyponatraemia and hyperkalaemia were fou...

A 17-year-old young lady presented with tiredness, weight loss, palpitations, hot flushes and irregular menstruation in April 2016 and her initial TFTs showed TSH <0.03 mU/l with a fT4 of 48.2 pmol/l. She was treated with carbimazole 40 mg daily and further investigation confirmed she had had Graves’ disease as TSH receptor antibodies (2.10 U/l), TPO antibodies (>1300 IU/ml), thyroid ultrasound scan demonstrated mildly enlarged and thyroiditis. She had only six period...

Case History: A female, aged eighty-three was admitted for an elective urology stent procedure. She had a background history of a non-functioning pituitary adenoma diagnosed 3 weeks before admission. This was found after investigation for headache and diplopia. The pituitary lesion was described as 18 × 17 × 14 mm in size and mixed solid/cystic in nature. There was no chiasmal compression. During that admission her case was discussed with neurosurgery and it was felt...

The short Synacthen test (SST) is used to evaluate adrenal glucocorticoid secretion in response to synthetic ACTH (also known as tetracosactide or Synacthen). Traditionally, after a baseline cortisol and ACTH, two plasma cortisol samples have been taken after i.v. or i.m. administration of Synacthen 250 μg, one at 30 min and one at 60 min. However practice varies and some physicians only take one cortisol measurement at 30 min.Hypothesis: A protocol...

A 51-year-old gentleman underwent a thyroidectomy 7 years ago for a benign multinodular goitre. Unfortunately, as a consequence of the surgery he became hypocalcaemic secondary to hypoparathyroidism. He was commenced on calcichew 1 tablet daily, calcium carbonate ‘500’ twice daily, vitamin D injections and 1- alphacalcidol 1 mcg daily. Initially, his PTH remained detectable and therefore it was hoped there would be some recovery, but over time this was proven not to ...

Introduction: Approximately 400 thyroid fine needle aspirates (FNAs) are performed annually at our institution. Many are repeat aspirates of Thy2 results. Current British Thyroid Association (BTA) and Royal College of Pathologists (RCPath) guidelines recommend two FNAs performed at least 6 months apart to confirm a benign result. Our aim was to investigate whether one Thy2 result is sufficient to confirm benign pathology.Method: A retrospective analysis ...

A 77 year old man with a background of Crohns disease requiring ileostomy, pernicious anaemia and hypertension, presented with a 4month history of dysphagia to solids, hoarseness of voice, anorexia and marked weight loss of 30 kg. He was initially referred to gastroenterology, who performed an endoscopy which was normal. Subsequently he was referred to the ENT and speech and language therapy departments. A video fluoroscopy confirmed severe oropharyngeal dysphagia with effortf...

A 27 year old lady with a background of Langerhans cell histiocytosis (LCH) presented to endocrinology clinic for investigation of thyrotoxicosis. At the age of three years old, she presented with a rash on her forehead, which on biopsy revealed Langerhans cell histiocytosis. She was also noted to have symptoms consistent with diabetes insipidus, for which she remains on desmopressin therapy. At the age of six she received pituitary radiotherapy and 6 years ago developed secon...

A 60year old gentleman was referred to endocrine team with new onset hyperthyroidism. He had developed tubulointerstitial nephritis secondary to carbamazepine resulting in ESRF 3 years previously. Four months prior to presentation he received a live-unrelated renal transplant including a single dose of Alemtuzamab post-operatively for induction of immunosuppression. Thereafter his immunosuppression was maintained with tacrolimus. Other medical history included bipolar disorder...

Polycystic ovary syndrome (PCOS) is associated with insulin resistance. Abnormally low glucose transporter 4 (GLUT4) expression has been shown in adipocytes from subjects with PCOS1 and skeletal muscle from type 2 diabetics2. Although GLUT4 expression is mostly restricted to classic insulin target tissues such as skeletal muscle, cardiac muscle and adipose, we have found it in granulosa cells (GCs) of mice3. Glucose uptake and metabolism by GCs...