Endocrine Abstracts

Introduction: Amiodarone, a drug with high iodine content, is commonly associated with thyroid dysfunction. There are two well-recognized forms of amiodarone induced thyrotoxicosis. Thyrotoxicosis due to iodine excess leading to increased thyroid hormone synthesis is referred to as Amiodarone induced thyrotoxicosis type 1 (AIT type 1) whilst thyrotoxicosis due to direct toxic effect (thyroiditis) is known is amiodarone induced thyrotoxicosis Type 2 (AIT type 2). The aim in bot...

A 68-year-old male presented with fatigue and acute onset polyuria and polydipsia. There was no history of headaches, visual symptoms, previous cranial radiations, chemotherapy or CNS infections. Investigations revealed normal fasting glucose, urea, creatinine, liver functions and electrolytes including calcium. Further workup including pituitary profile, paired osmolalities and water deprivation test confirmed hypopituitarism and cranial diabetes insipidus (Table 1). The unde...

61-year-old previously fit and healthy female presented with one-week history of confusion and altered consciousness. There was no history of fever, headache or limb weakness. She was dehydrated, Glasgow Coma Scale score was 11/15, pupils were equal and reactive to light bilaterally and rest of examination was unremarkable. Initial investigations are outlines in Table 1. X-ray-chest showed mediastinal lymphadenopathy and CT head was unremarkable. She was initially treated for ...

66 year old patient was diagnosed with macroprolactinoma and started on treatment with Cabergoline at a dose 250 μg twice weekly. Initial echocardiogram was normal and CT chest showed clear lung fields except mild left upper zone consolidation. During a routine follow up appointment 8 months after the initiation of treatment, the blood tests showed abnormal renal function and prolactin level was controlled. CT KUB showed features suggestive of retroperitoneal fibrosis lea...

AimTo assess relationship between serum calcium level and localization studies and management outcome.MethodologyRetrospective analysis of data for patients referred by primary care for hypercalcemia from 1/3/2019 to 1/3/2020 to the Endocrinology department at Royal Berkshire Hospital. The sample size was 63 which excluded normo-calcemic hyperparathyroidism as well as MEN1/2 patients.Re...

We present an interesting case of a 50-year-old woman with previous history of alcohol dependence, depression & oesophagitis who was brought to the emergency department by ambulance with vomiting, back pain and feeling generally unwell. Her GCS was 14/15, HR128/min, RR 32/min, BP 111/60, temperature 35.2 & CBG 11.2mmol. She reported consuming one bottle of Vodka every day. Initial venous blood gas analysis showed severe metabolic acidosis (pH 6.79, HCO3 3, Lactate 15, ...

The dexamethasone suppression test (DST) is a common screening test in Cushing’s syndrome but associated with false positive result in 10-20%. One cause of false positivity is inadequate dexamethasone absorption. An assay to measure serum dexamethasone concentration can be used to validate the accuracy of the DST result.Aims: To audit 1) Use of the dexamethasone assay in DSTs 2) How frequently dexamethasone levels are inadequate 3) ...

Case History with Investigations: A 65-year-old female, with no previous thyroid abnormalities, was originally referred to ENT with goitre. She was clinically and biochemically euthyroid, and following ultrasound with fine needle aspiration for right-sided nodules with benign cytology, was discharged. She was subsequently referred to Endocrinology with persistent lethargy and hair loss despite normal thyroid function. She described gritty eyes and swollen eyelids for 2 years, ...