Endocrine Abstracts

A 32-year-old male was referred by his GP with a 6-month history of lethargy, erectile dysfunction, weight gain, acne and hypertension. He denied exogenous steroid usage and had no other past medical history. On examination, he had classical features of Cushing’s including moon face, central adiposity, proximal muscle weakness and purple striae.Investigations confirmed Cushing’s from a pituitary source as shown in the table below. MRI pituitary...

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The long-term microvascular complications of diabetes are a significant cause of morbidity and predict mortality in diabetic patients. Multiple pathways have been implicated in the pathogenesis of each of these complications. Evolving evidence suggests that early intervention may have long-term benefits in preventing development and reversing these chronic complications.A major limitation in the approach to dealing with the microvascular complications is...

Administration of antenatal steroids for foetal lung maturity is considered for all women at risk for preterm birth before 37 weeks. Administration of two doses of betamethasone 12 mg intramuscularly, 24 hours apart may result in a deterioration of glycaemic control for 2–3 days in patients with gestational diabetes (GDM), thereby potentially affecting foetal wellbeing. Current practice was noted to be inconsistent, and a protocol was drawn up for variable rate insulin in...

A 36 M seen in endocrinology clinic October 2022 with 9/12 history of reduced testicular size and hypo gonadal symptoms. He has a past medical history of suicidal ideation and urinary incontinence. On review of previous GP records from 2003 he was seen for delayed puberty, although the patient denied this in clinic. There was no history of testicular trauma or infection and he denied any history of exogenous steroid or recreational drug use. There was no significant family his...

Purpose: To evaluate the outcome of different Radioactive iodine-131 activity range for the treatment of hyperthyroidism assessed at 6 and 12 months.Material/method: We retrospectively reviewed data of patients who received Radioiodine treatment for benign thyroid disorder at our center between 2013 to 2015. Indication for treatment, radioiodine activity administered, type of hyperthyroidism, and biochemical outcome of thyroid function at 6 and 12 months...

Hypercalcemia is commonly caused by primary hyperparathyroidism. Other causes of hypercalcaemia can be seen in the clinical setting, and it is important to consider these alternative diagnoses as the management differs dramatically from the management of primary hyperparathyroidism. We present a series of four patients presenting with four different granulomatous conditions causing hypercalcaemia. These were secondary to Tuberculosis, Sarcoidosis, Wegener’s granulomatosis...

A 73 year old female presented with collapse secondary to hypoglycaemia. Investigations are summarised in the table attached. In the presence of raised tumour markers and a raised IGF2/IGF1 ratio, carcinomatosis was considered as the most likely underlying diagnosis. Nutritional support was arranged with additional carbohydrate dietary intake advised. She responded well with reduced hypoglycaemic frequency of hypoglycaemia. Investigations for underlying carcinoma were unable t...

Introduction: Thionamides are first line treatment in the management of thyrotoxicosis; nevertheless several weeks of treatment is needed before euthyroidism is restored. This delayed and gradual action makes thionamides insufficient as sole treatment when acute control of the hyperthyroid status is mandatory, hence the need for potent yet rapid acting adjuvant antithyroid agent. Lithium is a monovalent cation that inhibits thyroid iodine uptake and hormone release with maximu...

Background: Insulin autoimmune syndrome (IAS) is characterised by spontaneous hypoglycaemia in the absence of exogenous insulin administration and high serum levels of immunoreactive insulin along with high titres of insulin antibodies. Although it is the third leading cause of hypoglycaemia in Japan, it is very rare in the western world. We present the first reported case of IAS in UK.Case report: A 27-year-old lady from south east-Asian background pres...