Endocrine Abstracts

Setting up a new service begins with identifying patient needs at both a local and national level, with the goal of producing higher quality and more sustainable services, improved health outcomes, reduced health inequalities and better models of care. Aims and objectives of the new service need to be clearly laid out early on, with the support and input from all stakeholders to ensure its wider acceptance and long-term success. Building a business c...

Background: Iatrogenic adrenal insufficiency (AI) refers to primary, secondary, or tertiary hypoadrenalism associated with drug administration, surgery, or irradiation. The most common cause of secondary adrenal insufficiency is exogenous glucocorticoids. Hepatic metabolism of inhaled corticosteroids (ICS) takes place via cytochrome P450 3A4. Nevertheless, it can be decreased by enzyme inhibitors such as itraconazole or ritonavir, thus leading to an increase in the bioavailabi...

Case history: A 30 years old male Caucasian had his saliva tested on a self-funded commercial DNA testing to identify his ancestral roots. The markers for Y chromosome were found to be absent and further evaluation revealed him to have 46 XX karyotype.This was consistent with the diagnosis of De la Chapelle syndrome or XX male syndrome. Fluorescence in situ hybridization (FISH) studies confirmed the presence of SRY (sex determining region Y) gene which was responsible...

Introduction: Although significant developments have been achieved in the management of steroid-dependent patients, little progress has been made in ensuring their safety using smartphone technology. We present the use of a novel app in steroid-dependent patients.Methods: A group of unselected individuals currently on steroid replacement due to adrenal insufficiency (AI) were assessed regarding their access to intramuscular (IM) hydrocortisone. A smartph...

Background: Radioiodine therapy (I-131) is commonly prescribed for benign thyroid disease in keeping with recommended guidelines.Aims: To determine the effectiveness of I-131 in treating benign thyroid disease and the rates of hypothyroidism following treatment and by diagnosis.Methods: We identified 100 patients who received radioiodine therapy between November 2013 and June 2015 from a database held in the Medical Physics Departm...

Introduction: Kikuchi-Fujimoto disease (KFD) is a benign self-limiting disease presenting with fever and lymphadenitis and mostly affecting adults younger than 40 years of age and of Asian descent. Its aetiology and pathogenesis are unknown though KFD often occurs in patients with concomitant autoimmune illness such as autoimmune thyroiditis or lupus erythematosus (SLE). We report a case of a patient with KFD and fluctuating thyroid function and thyroid autoantibody levels.</p...

Introduction: Hyperprolactinaemia is a common finding in endocrine practice and can be due to a number of causes. The degree of elevation of prolactin levels may sometimes be helpful in distinguishing between underlying aetiology.Aim: To determine if hyperprolactinaemia is correlated with clinical diagnosis in a cohort of patients in the endocrine service at a tertiary centre.Methods: A biochemistry database held at University Hosp...

Background: In December 2017, a Nurse-Led AI clinic was introduced at University Hospital of Wales, Cardiff for the evaluation and follow-up of these patients. The clinic pathway was based upon the 2016 European Society for Endocrinology (ESE) guidelines on the management of adrenal incidentalomas.Aim: To evaluate the effectiveness of this new service and the cost-saving benefit.Methods: Electronic and paper-based patient records w...

Case history: A 49-year-old male with hypertension (on doxazosin, amlodipine and perindopril), obesity (BMI 40 kg/m2) and recent DVT (on warfarin) presented with a few months’ history of episodic headaches, palpitations, light-headedness and sweats accompanied by facial pallor, occurring around twice weekly without warning. Symptoms were often worse when upright. Spontaneous recovery followed. He did not have a family history of endocrine disease. Clinical exam...

Abstract: The most commonly used techniques to measure vitamin D are automated immunoassays, which are known to be affected by interferences, especially from immunoglobulins present in the patient’s serum. We present a case of a patient with IgA myeloma in whom interference with the vitamin D assay was identified. An 76-year-old male, known to have: ischemic heart disease, atrial fibrillation, COPD, type 2 Diabetes Mellitus and hypertension was referred to the Endocrinolo...