Endocrine Abstracts

Intravenous iron formulations allow administration of high doses of elemental iron enabling correction of total iron deficit in one or two infusions. An underappreciated complication is hypophosphatemia from increased fibroblast growth factor 23 (FGF-23) secretion. An 85-year-old male presented with a second episode of generalized tonic-clonic seizures. The first episode was a month ago, and serum phosphate was 0.2 mmol/l (0.8-1.4). He was treated with phosphate replacement al...

A 20-year-old lady of Vietnamese origin presented with increasing frequency of headaches and worsening right sided weakness over 4 days. There was no other significant past medical illness, and she was not on any regular medication. She was not a smoker, and there was a history of thyrotoxicosis in her mother. Her heart rate was 110 beats per minute, and she was in sinus rhythm. On examination there was right sided weakness (MRC grade 4/5), expressive dysphasia, tremor of her ...

Case history: The patient was a 17-year old lady who was referred to us by her primary care provider for hyperprolactinaemia and primary amenorrhoea. She was of short stature (0.4th centile for height and minus 2 centile spaces of the mid-parental height) and in the 9th–25th centile range for weight. There was no history of galactorrhoea. Her breast development was Tanner stage 3–4, and pubic hair 2–3, with no axillary hair. There was no evidence of any intellec...

A 28 year old lady presented with a 4 month history of anxiety, palpitations, weight loss and a pressure sensation in the neck. On examination she had fine tremor of her outstretched fingers and no palpable goitre with a regular heart rate. FT4 was 22 pmol/l(10.3-24.5), FT3 7.9 pmol/l(3.5-6.5), TSH 0.02 mIU/l(0.3-5.5), TSH receptor antibodies (TRAb) <0.9 U/l(0-1.75) and TPO antibodies <4 IU/ml (0-35). She was started on Carbimazole 20 mg daily and after being well cont...

This case illustrates a decision paradox on investigations (to exclude secondary hypercalcaemia) and treatment options (in unresponsive thyrotoxicosis despite supra-normal doses of carbimazole). A 56-year-old lady, who was referred with hyperthyroid symptoms and evidence of biochemical thyrotoxicosis, was also found to have symptomatic hypercalcaemia (constipation & polyuria). Investigations were as follows: FT4 >100 pmol/l, TSH <0.02 mU/l, TRAb positive, Ca 3.0 mmol/l...

Diabetes is the leading cause of end stage renal failure. So, identifying patients at risk and intensifying management of blood pressure, lipids and glycaemic control can reduce and delay progression to organ replacement therapy. The aim of our study was to determine whether our pilot 3 monthly joint diabetes-renal clinics set up in April 2018 was able to achieve targets outlined by national guidelines and whether patient satisfaction and improved outcomes could lead to furthe...

We present the case of a 22-year-old male patient who posed a diagnostic dilemma due to discrepancies between his symptoms and biochemical markers in contrast to imaging findings. He reported a 18 month history of on and off neck swelling with associated symptoms of anxiety, tremor, loose stools and dry eyes (no weight loss). Thyroid function tests were normal with a Free T4 (FT4) of 12.4 pmol/l (12-22 pmol/l), TSH 2.75mU/l (0.27-4.2mU/l) and an ultrasound showed an enlarged a...