Endocrine Abstracts

A 44 year old man attended our endoscopy unit for gastroscopy to further investigate ongoing epigastric pain. He was incidentally found to be very hypertensive so gastroscopy was cancelled. Hypertension was treated. He had past medical history of hypertension and Gout. Routein blood tests showed renal impairment with significantly raised calcium 3.19 mmol/l. Hypercalcemia was treated with iv bisphosphonates. MEN 2a, was considered as a unifying diagnosis for high calcium and h...

A 32-year-old man was urgently referred to the endocrinology and neurosurgical teams by the neuro-ophthalmologist. He gave a 3 week history of sudden onset of left-sided visual impairment, with further visual deterioration a week previously. Urgent review in the eye clinic had revealed that the visual acuity in his left eye was reduced to finger counting only, with a pale left optic disc and a relative afferent pupillary defect on examination. Visual field testing demonstrated...

A 55-year-old lady was admitted with sudden onset headache, diplopia, photophobia and confusion. CT brain showed SAH with hydrocephalus. Coiling of the aneurysm with EVD insertion was done on the same day. On day 5 post-operatively she developed hyponatremia and dropped her GCS to 10/15.On examination she was volume depleted with dry mucous membranes and loss of skin turgor. Urine output over the previous 4 days had been 2.5–4 l/day, urinary sodium ...

Pituitary metastases are uncommon, with breast and lung carcinomas being the most common primary sites. Of the minority that are symptomatic, diabetes insipidus (DI) is frequently present. We report two cases, one presenting with DI and the other with hypopituitarism and DI, who deteriorated rapidly and died within 3 months.Case 1: A previously fit 53-year-old lady presented in December 2008 with a one month history of polyuria and polydipsia. Investigat...

Primary aldosteronism (PA) uncommonly presents during pregnancy. Uncontrolled blood pressure may result in adverse maternal and fetal outcomes. We report a case presenting in pregnancy whose management proved particularly challenging, due to variable compliance with therapy, frequent non-attendance at clinic, a subsequent pregnancy and negative imaging.A 24 year old woman presented at 26 weeks gestation with severe pre-eclampsi...

Primary aldosteronism (PA) uncommonly presents during pregnancy. Uncontrolled blood pressure may result in adverse maternal and fetal outcomes. We report a case presenting in pregnancy whose management proved particularly challenging, due to variable compliance with therapy, frequent non-attendance at clinic, a subsequent pregnancy and negative imaging.A 24 year old woman presented at 26 weeks gestation with severe pre-eclampsi...

Introduction: Immobilization hypercalcemia (IH) is more common in children and adolescent due to increased rate of bone turnover and it usually develop 4–6 weeks post trauma but it can begin as early as 2 weeks and as late as six months. We report a patient who developed severer hypercalcemia after sustaining multiple fractures and immobilization.CaseA 24-year-old man was admitted for neurorehabilitation after road traffic acc...

Hypomagnesaemia usually occurs secondary to decreased intestinal absorption or excessive renal excretion. There have been a few reports recently suggesting an association between PPIs and hypomagnesaemia.A 65-year-old lady was referred to the endocrine clinic for investigation of hypomagnesaemia found on routine testing. Serum magnesium was 0.27 mmol/l (normal 0.7–1.0), with corrected serum calcium of 2.0 mmol/l (2.12–2.63), and normal PTH and ...

Introduction: To assess outcome for patients with acromegaly treated at Royal Preston Hospital since 1st of January 2000.Results: Out of 22 patients (12 presenting in the last 2 years) 20 had endoscopic transsphenoidal hypophysectomy and two were managed medically. Headaches, visual disturbance and characteristic morphological features were the main presenting problems. 4 were microadenomas and 18 macroadenomas\. Exact dimensions were only available in 1...

Background: Radioiodine therapy using I131 is a well established, safe, cheap and effective treatment for thyrotoxicosis. Current recommendations support the administration of 400-550 Mbq. At this centre, we use a dose of 550 Mbq with the aim of minimising the chance of the patient remaining thyrotoxic following therapy.Aims: To determine (a) the thyroid status of patients following treatment with I131 at a dose of 550 Mbq, (b) the ...