Endocrine Abstracts

Background: Neuroglycopenic symptoms in insulinoma could persist for years before localising the source of endogenous hyperinsulinaemia. 90% of insulinomas are sporadic, solitary and < 2 cm in diameter, and can be associated with multiple endocrine neoplasia-1 (MEN-1). Insulinoma is an emerging clinical entity with a huge diagnostic challenge as tumour growth varies from months to years before tumour localisation.<p class="abstext...

Background: Neuroglycopenic symptoms in insulinoma could persist for years before localising the source of endogenous hyperinsulinaemia. 90% of insulinomas are sporadic, solitary and < 2 cm in diameter, and can be associated with multiple endocrine neoplasia-1 (MEN-1). Insulinoma is an emerging clinical entity with a huge diagnostic challenge as tumour growth varies from months to years before tumour localisation.<p class="abstext...

Background: Gastric reduction duodenal switch involves restrictive and mal-absorptive aspect, removing approximately 70% of stomach and most of the duodenum. Surgical alteration leading to malabsorption of macronutrients is achieved with varying results of weight loss but resulting nutritional side effects are under-recognised. Issues in nutritional complication leading to neurological complications like peripheral neuropathy are increasingly recognised. We discuss a case of s...

Background: Bariatric surgery has contributed to a large spectrum of presentations of hypoglycaemia. Dumping syndrome caused by food reaching the duodenum rapidly is associated with abdominal pain, bloating and diarrhoea as well as vasogenic symptoms of tachycardia and flushing. Hypoglycaemia may occur as a late sign of dumping 1–3 hours after a meal. In contrast, post-gastric bypass reactive hypoglycaemia is thought to result from discordance between blood glucose circul...

A 34 year old male, previously healthy nightclub doorman presented with 2 years of reduced libido, fatigue, hot flushes and reduced beard growth. He had fathered three healthy children. He admitted to previous use of veterinary anabolic steroids up until 2 years ago. He had normal secondary sexual characteristics, no features of pituitary hypersecretion, normal visual fields but reduced testicular volumes (8 ml).Biochemical investigation showed growth ho...

Objective: To evaluate the efficacy of medical management of hyperparathyroidism and evaluate the financial and healthcare impact of delay in surgical intervention within a district general hospital. To assess the duration of use of cinacalcet prescriptions, compare wait times for surgery and assess the service needs.Method: We retrospectively evaluated all patients with primary hyperparathyroidism who received cinacalce...

Context: Parathyroid carcinoma is a very rare malignancy. It arises as a separate structure rather than from a pre-existing parathyroid adenoma. It may be difficult to differentiate it from parathyroid adenoma based on histology. When evaluating primary hyperparathyroidism clinical correlation should be taken into account. Clinical features of parathyroid carcinoma may include male gender, palpable neck nodule and higher parathyroid hormone and serum calcium levels associated ...

Background: Severe obesity, BMI ≥40 kg/m2, confers a greater risk for graft loss and mortality among renal transplant patients. Transplantation provides a better survival and quality of life in overweight dialysis patients. Higher BMI is associated with progressively increased risk of CKD stages 4–5, hazard ratio of 3.10 (CI 2.95–3.25) for BMI ≥35 kg/m2. A recent meta-analysis found pre-transplant BMI <30 kg/m2 is asso...

Background: Tuberculosis (TB) is an important cause of mortality and morbidity globally. Only a small proportion cases of systemic TB present with lesions spreading to meninges, sella, or ventricles. Cases of intra-sellar pituitary adenoma secondary to TB have been rarely identified, often with uncertainty on medical management as opposed to more aggressive surgical therapy. We report an interesting case of pituitary adenoma presenting with pan-hypopituitarism and posterior pi...

A male in his 40’s diagnosed with type 2 diabetes in 2011 (BMI:20.7kg/m2) was admitted with DKA (Dec 2018) after a period of poor glycaemic control on oral hypoglycaemic agents (Feb 2017: HbA1c-105mmol/mol, Nov 2018: HbA1c-115mmol/mol). There was dramatic improvement in glycaemic control after commencing him on subcutaneous insulin (April 2019: HbA1c-56mmol/mol). GAD65 antibodies were positive (24u/mL; normal<5u/mL) and a diagnosis of latent autoimmune diab...