Endocrine Abstracts

Introduction: Amiodarone is a widely used antiarrhythmic drug for refractory atrial or ventricular tachyarrhythmias. Amiodarone-induced thyrotoxicosis (AIT) occurs in up to 6% of patients taking this medication in iodine-sufficient areas of the world and in up to 10% in iodine deficient areas. AIT is of two types: type 1 is a form of iodine-induced hyperthyroidism whereas type 2 is a drug-induced destructive thyroiditis. Type 1 AIT tends to occur in patients with underlying th...

An 82-year-old lady admitted after multiple episodes of collapse and her blood sugar levels were noted to be less than 2.0 mmol/l. A supervised controlled fasting test was performed and results were consistent with Insulinoma. Imaging revealed a mass in the tail of the pancreas with metastasis to the liver. Liver biopsy confirmed the diagnosis of a poorly differentiated neuroendocrine tumour. She continued to have hypoglycaemic episodes which were difficult to manage. Dietary ...

32 year old female with no prior past medical problems presented to hospital with a two week history of rapid onset delusional psychosis with religious themes, paranoid ideas and rapidly developing into catatonia. There was no previous history of psychiatric disorders. On physical examination the Glasgow Coma Score (GCS) was 15 and she was responding to visual hallucinations; speaking to imaginary person and reported seeing objects. She was afebrile and bedside observations we...

A 36 year old female patient presented to the emergency department with a generalised tonic-clonic seizure. She had a past medical history of epilepsy and tuberous sclerosis. Her medication prior to hospital admission was Tegretol which had controlled her seizures well for many years. On admission, the adjusted calcium level was 1.4 mmol/l with a raised ALP 508 U/l and a phosphate within the normal reference range at 1.1 mmol/l. Magnesium was also within the normal reference r...

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...

Tyrosine kinase inhibitors (TKIs) are relatively new therapy drugs used for the treatment of metastatic cancers including Renal cell carcinoma (RCC), gastrointestinal stromal tumours, thyroid and neuroendocrine tumours. They block vascular endothelial growth factor and other growth factors Thyroid dysfunction is often a side effect of this treatment. A close monitoring of thyroid hormone levels is a necessity.We have a case of a 69-year-old lady with RCC...

Aim: Baseline clinical and biochemical endocrine assessment at the start of immune checkpoint treatment and each treatment cycle is important given the treatable nature of it. Also given the improvements in survival of these patients necessitate further longterm screening. Our study was to look at various aspects of this screening with a view to improve our knowledge and also patient care.Methods: Using an excel database, a retrospective data collection ...

Introduction: Vitamin D deficiency is increasingly being recognized as a metabolic disorder in temperate climates with various bone, cardiovascular and systemic manifestations. However topical, it is important to exclude tumour induced osteogenic osteomalacia as a possible aetiology in severe vitamin D deficiency when other risk factors (vegetarian diet, ethnicity, etc.) are absent. Early diagnosis of malignant tumors could be life saving and their resection may make this vita...

Introduction: Vitamin D deficiency is increasingly being recognized as a widely prevalent metabolic disorder in temperate climates with various systemic manifestations. However topical, it is important to exclude tumour induced osteogenic osteomalacia as a possible aetiology in severe vitamin D deficiency when other risk factors (vegetarian diet, ethnicity, etc.) are absent. Early diagnosis of malignant tumours could be life saving and their resection may make this vitamin D r...

We report a case of a 20-year-old male with a clinical profile of Gorlin-Goltz syndrome with delayed puberty. This 20-year-old man had learning disablitiy, macrocephaly and multiple jaw cysts. His other clinical features included agenesis of the carpus callosum, obesity and multiple cutaneous lesions suggestive of angiolipomata. His pubertal development was delayed although a LHRH test done at the age of 16 showed a normal response. Radiological features included macrocephaly,...