Endocrine Abstracts

60 year old gentleman referred to endocrine clinic from Rheumatology for raised PTH 23.5 pmol/l, in the context of normal calcium 2.2 mmol/l, low vitamin D 27.3 nmol/l, raised ALP 273 U/l, low phosphate 0.57 mmol/l and normal renal function. Past medical history of hypertension, Barrett’s oesophagus, cluster headaches and previous left femur fracture secondary to motor cross accident. The ALP isoenzyme for bone was raised. He was complaining of backache which he had for s...

We reviewed the outcomes of 40 patients (30F, 10M; mean age 56 years) with thyrotoxicosis who were referred for radioactive iodine treatment (RAI) via our department (catchment area of 130 000 people) over a period of 3 years (February 2004–March 2007). Twenty-three patients had Graves (GD); 6 had single toxic adenoma (STA); 11 had toxic multinodular goitre (MNG). Thirty-six patients (90%) had a preceding isotope scan, and 2 patients (5%) had previous partial thyroidectom...

Background: Severe hyponatremia can be associated with oxytocin infusion. The incidence of hyponatraemia after oxytocin is around 5%. There are reported cases of serious neurological complications including seizures, coma and maternal death.Case report: A 37-year-old female with known partial central diabetes insipidus following a head injury was established on Desmopressin nasal spray 10 mg twice a day. She had an uneventful pregnancy on the same dose. ...

Case history: A 67-year-old lady was referred to endocrinology with an 8-year history of mild hyperparathyroidism with Parathyroid hormone of 7.4 -15.3 pmol/l (Normal -1.95-8.49). Her corrected calcium ranged from 2.46-2.66 mmol/l (Normal 2.2 -2.62), phosphate 0.63 -1.0 mmol/l (normal 0.8-1.5), normal renal function and normal vitamin D. Her urine calcium to creatinine ratio was 0.7 mmol/mmol (Normal 0-0.4).Investigations and treatment: She had myalgia d...

Thyrotoxicosis is a relatively common condition affecting 1–2% of women and 0.1–0.2% of men. Common symptoms are usually straightforward and easily identified. Rarer presenting features such as confusion and headache have been published in the literature as case reports. We hereby report two cases of Graves Thyrotoxicosis presenting unusually and therefore misleading the initial diagnostic pathway. The first case is a 45-year-old female with a 4-day history of headac...

A 77-year-old lady presented with reduced conscious state, dysphasia and profound confusion on a background of behavioural change and anorexia over the previous 10 days. She was previously independent with history of hypertension controlled on atenolol (100 mg). She was significantly hypertensive 200/100. Her serum calcium was elevated at 4.01 mmol/l (2.05–2.60). The serum parathyroid hormone (PTH) was also significantly elevated at 26 pmol/l (0.5–6.4) consistent wit...

Background: Atypical carcinoid tumours are rare which account for about 15% of all carcinoid tumours. Some of those tumours secrete adrenocorticotrophic hormone (ACTH) causing Cushing's syndrome. We present a case which recurred 16 years after being first diagnosed.Case: A 39 years old woman was referred with few months history of weight gain, irregular menstrual periods, muscle aches, difficult going up the stairs, headaches and blurred vision.She was i...

Objective: To examine the monitoring, management and outcomes of adrenal tumours in pregnancy.Design: A national, prospective observational, cohort study over 4 years using the UK Obstetric Surveillance System (UKOSS).Setting: Consultant led obstetric units.Patients: Women with hormone-secreting adrenal tumours (pheochromocytoma, primary aldosteronism or Cushing’s syndrome) diagnosed before or during pre...

Case History: A 61-year-old Caucasian female from Ukraine presented with severe hypercalcaemia following routine blood tests performed by the GP. She reported symptoms of back pain and joint pains. She had renal stones 10 years prior. No history of thiazide or lithium use. No red flags; no change in appetite or weight loss. There was no familial history of Multiple Endocrine Neoplasia (MEN). Examination of her neck, cardiorespiratory, abdomen and breasts were normal. <p cl...