Endocrine Abstracts

A 66-year-old man was referred in May 2004 with history of rapid onset of diabetes, severe back pain with vertebral collapse and hypokalaemia (K+2.9 mmol/l). GP suspected Cushing’s syndrome. Random cortisol was 905 nmol/l and 24 h urinary free cortisol 1741 nmol/24 h.He was admitted for investigations which were highly suggestive of ectopic ACTH secretion with cortisol levels failing to suppress after low- and high-dose dexamethasone and ACTH levels...

Background: Adrenal incidentalomas are classified as adrenal lesions picked up on imaging performed due to reasons other than to look at the adrenals. With cross sectional imaging becoming more frequent, the frequency of adrenal lesions being detected and referred to endocrine services is increasing and dedicated adrenal incidentaloma clinics are being set up to screen these patients for potential pathology.Case: We present a 63 year old lady who underwe...

Clinical presentation: This 32 year old lady was referred with a history of weight loss, sweating, tremor and anxiety and biochemical hyperthyroidism; fT4 41 pmols/l (9.00–25.00 pmols/l) TSH <0.05 miu/l (0.30–5.00 miu/l); strongly positive TPO antibodies (1600 IU/ml.). She was toxic clinically, had subtle left sided proptosis and a palpable left sided thyroid nodule. She was started on carbimazole 20 mg and the initial differential diagnosis was between Grave&#14...

Background: A large proportion of patients who attend the Endocrine clinic have thyroid dysfunction, usually thyrotoxicosis. These patients require regular thyroid function tests (TFTs) and advice on medication dose alteration, usually through frequent clinic appointments. At our University Teaching Hospital, we have a nurse-led system whereby TFT monitoring and advice is managed virtually, with patients usually attending clinic annually for review. We call this the Thyroid Sh...

Patients with Adrenal Insufficiency are potentially at risk of life threatening events if during intercurrent illness they do not take adequate glucocorticoid replacement. The National Institute for Health and Care Excellence Clinical Knowledge Summaries for this patient group recommend that they should: know how to self inject intramuscular hydrocortisone in an emergency; how to adjust their steroid replacement in response to illness; understand the importance of medical iden...

The Competency Framework for Adult Endocrine Nursing was launched at the Society for Endocrinology (SfE) BES conference in March 2013 and was made available to Endocrine nurses and Endocrine centres in the UK. It was also made accessible via the SfE website. Questionnaires were sent out 6 months later to audit its use.Results: 80.4% of nurse respondents had heard of the document and 69.6% had read it. 100% of those who had read it found it easy to use an...

The Society for Endocrinology Nurse Committee provides national, international and local guidance, support and networking for nurses working in Endocrinology. Following review and revalidation of the endocrine nurse certificate, the Nurse Committee looked to explicate adult endocrine nurse competencies. The need for core competencies to standardise role expectations was a concern voiced from nurses and committee members. Up to the introduction of paediatric endocrine nurse com...

Introduction: Achieving optimal levothyroxine replacement is more difficult in TSH deficiency compared to primary hypothyroidism because of the inability to be guided by TSH. A combination of clinical symptoms and free thyroxine levels (fT4) are typically used to monitor replacement. We reviewed adequacy of levothyroxine replacement in our patients with pituitary disease, and compared with fT4 levels in patients with primary thyroid disease.<p class="...