Endocrine Abstracts

A 38-year-old woman presented with tremor and anxiety 3 weeks into her pregnancy and was diagnosed with thyrotoxicosis. One year postpartum, the thyroid appeared multinodular with a dominant nodule that showed deficient uptake on the technetium scan. Her thyroid function was normal and thyroid peroxidase antibodies were negative. She developed an enlarging goitre and underwent total thyroidectomy following which she developed persistent hypocalcaemia and hypomagnesaemia.<p...

It is paramount to educate our patients, thereby empowering them to manage their chronic conditions. This is an evidence based fact. As healthcare professionals our challenge is to provide and ensure patients have been well informed in order to understand and manage their condition successfully on a daily basis.In today’s healthcare service patient education has become a casualty of the reduced resources; there are ever increasing restrictions on bo...

We present a 37-year-old gentleman (Mr. A) who self-referred to the endocrine clinic for review of his testosterone replacement therapy.He required testosterone replacement therapy aged 11 years old following surgical removal of underdeveloped testes of unknown aetiology. He was prescribed testosterone injections until the age of 22 years old when testosterone patches were trialled, which he did not tolerate. He commenced testosterone replacement gel (TE...

Testosterone deficiency syndrome (TDS) may well contribute to a number of co-morbidities and multitude of symptoms which may affect one’s daily activities adversely. TDS prevalence in UK is 5:1000 and certain groups of patient’s are at higher risk of TDS, in particular elderly and patients with diabetes mellitus where 42% are known to have TDS. A retrospective audit was carried out to bench mark our practice in line with a publication of a recommended National/Europe...

We present the case of a 51-year-old gentleman who had a giant parathyroid adenoma. He has a past medical history of deep vein thrombosis and hypertension. He is taking amlodipine 10 mg od. He is a non-smoker and drinks alcohol in moderation. He was admitted with right leg swelling found to be a new thrombosis. Incidental finding of extreme hypercalcaemia found on bloods with raised PTH (CorrCa 4.23 mmol/l, PTH 83.1 pmol/l.) Patient was completely asymptomatic. CT imaging of c...

A 37 year old woman was referred to the endocrinology clinic from the gynaecologists. She was awaiting an 8 cm left ovarian cyst removal and found to be hyperthyroid (fT3 7.8 pmol/l, fT4 of 19.0 pmol/l, TSH <0.01 mU/l). She described 4 months of palpitations, change in bowel habit and menstrual irregularity. She had no tremor or tachycardia. She had no palpable goitre or eye signs. She had a past medical history of asthma on inhalers. There was no family history of thyroid...

In the National Health Service (UK), there are ever increasing demands to streamline care and develop patient pathways and guidelines as justification for any test or procedure. This is to ensure optimisation in patient care and experience.The role of a specialist nurse focuses on ensuring appropriateness and swiftness of investigations, including providing a high level of clinical care which has its foundations on communication and education for the pat...

Case: A 46-years-old anaesthetist presented with 2 weeks history of general malaise, sore throat, and fever. Symptoms started while on holiday. A diagnosis of subacute thyroiditis was made overseas based on presentation and suppressed TSH level. He was started on betamethasone 4mg and ibuprofen for 2 weeks with rapid symptomatic improvement. He felt well enough to travel back to UK. He then presented to our hospital with recurrent symptoms as above.Inves...

Insulinomas are rare neuroendocrine tumours that classically present with a combination of symptomatic hypoglycaemia, low serum glucose values and resolution of symptoms post glucose ingestion.We describe a 65-year-old lady who repeatedly presented over several years with recurrent infections, predominantly of the urinary tract, nausea and diarrhoea, necessitating frequent hospital admissions. Despite extensive investigations, no clear cause for her symp...

Introduction: Doxycycline is a broad-spectrum antibiotic that is used to treat gram negative, gram positive and atypical bacterial infections. It is a member of the second-generation tetracycline class of antibiotics.Case: We describe a case of a (non-diabetic) male patient who developed hypoglycaemia following treatment with doxycycline. A 73-year-old male presented to the emergency department following a witnessed collapse at 9am on the 4tho...