Endocrine Abstracts

Incidence of Type II Diabetes Mellitus (T2DM) is increasing; majority of which is managed in primary care. NICE recommends starting Metformin as a first-line therapy. Studies have linked Metformin use with Vitamin B12 deficiency and suggest that regular monitoring of levels is warranted. The pathogenesis is not fully understood. Literature suggests that the risk of developing B12 deficiency is greatly influenced by high doses and long duration of therapy. An audit was conducte...

Background: Managing mental health patients with Diabetes Mellitus can be challenging. Patients with mental health problems are poorly compliant with both antipsychotic and diabetes treatment. Literature has suggested that some psychiatric illnesses can be independent risk factors for diabetes. Furthermore, diabetic patients have a higher incidence of psychiatric disorders. There is a causal relationship between newer antipsychotic medications and metabolic abnormalities.<...

Background: Spontaneous coronary artery dissection (SCAD) is a rare condition, which is sometimes underdiagnosed in patients with chest pain and presumably normal coronaries. There have been a few case reports of patients with thyroid dysfunction and arterial dissections.Case: We present a 20 year old female with recent diagnosis of Graves’ thyrotoxicosis managed with methimazole. She initially presented in South Korea with shortness of breath on ex...

Aim: To evaluate the feasibility of non-face to face (NFTF) contact in the follow-up for patients with thyrotoxicosis on carbimazole therapy.Background: While on carbimazole, achievement of a euthyroid state may involve multiple clinic appointments. We hypothesize by conducting these appointments in a NFTF setting, i.e. telephone consultation with trained nurse practitioner supported by an Endocrine consultant; a higher volume of consultations can occur ...

Introduction: Hypercalcaemia is a commonly encountered biochemical abnormality. The most common causes of hypercalcaemia are primary hyperparathyroidism and malignancy. Familial Hypocalciuric Hypercalcaemia (FHH) is a rare cause of hypercalcaemia.Case: We present a 53-year-old female, who was referred to the endocrinology clinic for further investigation of a persistent hypercalcaemia associated with low-to-normal parathyroid hormone level (1.5pmol/l). S...

Hypokalemia is a common and potentially fatal electrolyte disturbance, especially in hospitalised patients. Therefore, prompt assessment and management is vital to avoid serious complications. We report a case of 77 Year old gentleman with a background of Alzheimer’s presenting with abdominal distension, intermittent diarrhoea and shortness of breath. He had normal blood pressure with no signs of Cushing syndrome but was found to have hypokalaemia. Plain imaging revealed ...

Traditionally, patients diagnosed with primary hyperparathyroidism present with mild hypercalcaemia and tend to be asymptomatic. Symptomatic patients tend to have severely high calcium and exhibit the classic ’bones, stones, abdominal moans and psychic groans.’ We present a case of a 92-year-old Caucasian gentleman presenting with recurrent falls, postural hypotension and trauma to head and shoulder. X-ray imaging showed small non-specific lucencies in the cervical a...

Bilateral adrenal haemorrhage is an uncommon but life-threatening condition which may result from trauma, sepsis, coagulopathy, underlying tumour or autoimmune conditions. We present a 62-year-old female with a history of well controlled hypertension and asthma who was admitted with sudden onset epigastric pain and suspected cholecystitis. She received her first dose of Astrazeneca (AZ) Covid-19 vaccine seven days prior to onset of symptoms. Her systolic blood pressure was mor...

We would like to describe a case of resistant hyponatraemia. A 65-year-old Caucasian male presented to ED with a two-day history of blurred vision and transient numbness in his right hand. He was an ex-smoker with a past medical history of a transient ischaemic event in 2019 and a myocardial infarction in 2005. He admitted to a 10kg weight loss. He had no changes to his medications in the recent past which included lansoprazole, ramipril, mirtazapine, atenolol, clopidogrel, at...

Oncogenic ostemalacia is a rare paraneoplastic syndrome characterised by renal phosphate wasting secondary to secretion of FGF-23 from mesenchymal tumours. Localisation of the tumour is wanted, as resection can lead to complete clinical and biochemical cure. We present a case of a 57 year old woman with a background of Vitamin D deficiency and secondary hyperparathyroidism, who presented with severe generalised aches and pain, worst in her ribs and thighs, such that she could ...