Endocrine Abstracts

A 50-year-old woman with learning difficulties and schizophrenia presented to accident and emergency with 5 days of epigastic pain and vomiting.Initially, she was peripherally shut down, with a pulse of 120 and blood pressure of 115/80. Chest examination was normal. Abdominal examination showed epigastric tenderness with guarding.Blood tests confirmed a diagnosis of acute pancreatitis (Amylase 1972 IU/l), with hypercalcaemia (corre...

We present a 59-year-old lady referred to us with worsening fatigue, arthralgia and dizziness over several years. Other symptoms included sleep disturbance, headaches, occasional palpitations and sore eyes. There was no family history of thyroid illness. Her medications included Vitamin B, Vitamin C, Hi 5 vitamin supplement, calcium, and zinc. On further questioning, she was taking kelp supplement (2 tablets per day) as recommended by a nutritionist, for treatment of ‘slu...

Background and aims: Antithyroid medications are first line treatment for thyrotoxicosis in the UK. The risk of agranulocytosis is ~1:2000 cases. Between 1963 and 2003, 809 adverse reactions related to antithyroid medications were reported. Of these 179 were due to agranulocytosis. Forty-two fatal events were recorded and half of these were related to agranulocytosis.Patient awareness is vital in preventing drug associated morbidity and mortality. We con...

A 59-year-old lady with headaches and malaise was found to be hypertensive with a blood pressure (BP) 210/105. An MRI brain revealed a haemorrhagic lesion in the right temporal lobe. There were no other signs of end organ damage. Her medications included atenolol 25 mg OD, ramipril 10 mg OD and bendroflumethiazide 2.5 mg OD. It transpired that she has been drinking 5 cups of liquorice tea per day over the last 18 months. Following a vomiting illness she stopped liquorice tea c...

A 71-year-old man with carcinoma of prostate and bony metastasis, presented with acute bradyarrhythmia, severe hypocalcaemia and acute renal failure 72 h after intravenous infusion of zoledronate. Before therapy, serum calcium was 2.14 mmol/l (normal, 2.10–2.55 mmol/l), serum phosphate 1.4 mmol/l (normal, 0.8–1.5 mmol/l), serum creatinine 95 umol/l and eGFR 74 ml/min. 25OH vitamin D was not measured. Three days later he presented with a syncopal episode. Initial bloo...

We describe two cases of sarcoidosis associated hypercalcaemia, renal failure and anaemia mimicking lymphoma. The diagnosis was made by lymph node biopsy. Within weeks of starting oral steroids, symptoms resolved and biochemical abnormalities almost normalized.Case 1: A 66-year-old lady, presented with generalized weakness, lymphadenopathy and splenomegaly. Hb 96 g/l, MCV 91, urea 16.6 mmol/l, creatinine 227 umol/l, eGFR 15 ml/min, serum calcium 3.4 mmol...

Adrenal/periadrenal sarcomas are very rare entity of adrenal tumours. An epidemiological analysis of primary adrenal cancers found prevalence of adrenal sarcoma of 1.3% compared to adrenocortical carcinoma (ACC) 43.8%, neuroblastoma 39.7%, pheochromocytoma 10.9% and non-Hodgkin’s lymphoma 4.3% (1). In 2021, 26 adrenalectomies in adults were performed in our institution. 12/26 had malignant histology. 9/26 lesions were > 6 cm. 7/9 lesions > 6 cm were malignant (2 a...

Hypophysitis describes inflammatory pituitary lesions which can be classified into lymphocytic (autoimmune), granulomatous or xanthomatous. Rathke’s cleft cysts (RCC) are usually assymptomatic, benign tumours derived from remnants of Rathke’s pouch. We present a case of lymphocytic hypophysitis secondary to a ruptured RCC and the first reported case of post-surgical recurrence.A 34-year-old female presented with secondary amenorrhoea and fatigu...