Endocrine Abstracts

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...

Background: Group education for patients with diabetes is a well validated method of enhancing self-management skills. More recently some departments have used group education to teach endocrine patients how to administer IM hydrocortisone.Innovation: Patients on steroid replacement, identified by the endocrine nurse and GPs, were invited to attend a group session. The aim was to ensure every relevant patient in the locality had the opportunity to be edu...

A 67-year male presented to his GP with polydypsia, ployuria and bone pains. Routine blood tests showed hypercalcemia (corrected calcium 2.77 mmol/l). Patient was otherwise well. He had a history of ethanol abuse, hypertension and gout.Medications: Allopurinol, ramipril simvastatin and co-dydramol. Repeat blood tests after 4 weeks show a rising calcium of 3.24 mmol/l with intact PTH 33.6 pmol/l (<6.4). He was referred to our endocrinology department ...

We present a 52-year-old lady with type 2 diabetes mellitus, referred by her GP with poor glycaemic control. Her past medical history included haemochromatosis, undifferentiated connective tissue disorder, depression, hypothyroidism, pernicious anaemia and alcohol abuse. Relevant medications were metformin 1 g bd, novorapid 28 units tds, levemir 30 mg od and prednisolone 5 mg od. Her HbA1c was 8.1%, renal function and baseline pituitary function was normal. Following an admiss...