Endocrine Abstracts

Case: A 62-year old man with a previous diagnosis of asymptomatic subclinical hypothyroidism (TSH: 13.6 mU/L, FT4: 23 pmol/L) and elevated TPO antibody titres (>600 IU/ml) was referred with persistently elevated TSH levels despite increments in the dose of thyroxine. Thyroid function test (TFT) on 200 mcg of thyroxine showed an elevated TSH (13.0 mu/L) and FT4 (31.1 pmol/L). Thyroxine was gradually reduced and stopped. Following this, although FT4 levels normalised (20.7 p...

A 34-year-old lady with previous renal stones, constipation and well controlled bipolar mood disorder, on lithium for 13 years, was referred with a high calcium of 2.75 mmol/l (normal range: 2.10–2.58 mmol/l) and raised parathyroid hormone of 9.1 pmol/l (normal range: 1.1–4.2 pmol/l). Urine calcium excretion and TFT were normal.The biochemistry was consistent with primary hyperparathyroidism. A workup for possible underlying MEN syndrome came b...

Introduction: Hypoglycaemia is a common event encountered in patients with type 1 diabetes usually due to an imbalance between diabetic therapy, activity level and dietary intake.Case: We report a case of a 31-year old lady with 20-year history of type 1 diabetes on basal-bolus regimen of insulin, who presented with a 2 month history of secondary amenorrhoea and recurrent disabling hypoglycaemia despite significant reduction in insulin doses. Clinical ex...

Case Report: A lady of 43 presented with an insidious onset of weight loss, lethargy, muscle pains, and more recently; polydipsia, nausea and vomiting. She had been recently started on levothyroxine for primary hypothyroidism. She was hypotensive and tachycardic. Investigations revealed Sodium 123 mmol/L (133–146), Potassium 5.0 mmol/L (3.5–5.3), Urea 16.2 mmol/L (2.5–7.8), Creatinine 153 umol/L (45–90) and calcium 3.4 mmol/L (2.1–2.6). PTH was <0....

Primary hyperparathyroidism in pregnancy can be associated with serious complications. Maternal complications include, increased risk of pre-eclampsia/eclampsia, miscarriage, arrythmia during labour/delivery, and still/premature birth. Neonatal complications include risk of permanent hypoparathyroidism, tetany, seizures, hypotonia, low birth, weight and respiratory distress. Early part of second trimesters is the best time to operate, as risks of surgery and anaesthesia are mi...

Background: The short- and long-term clinical outcome of patients receiving radioactive iodine treatment (RAI) differs in various studies. There is little consensus regarding the most appropriate dose of RAI to be administered. The range of activities currently prescribed varies between 200 and 800 MBq, with majority of patients receiving 400–600 MBq. In our centre, all patients receive a standard fixed dose of 400 MBq.Aim: To assess the cure rate w...

Introduction: Myxoedema coma is a rare complication of hypothyroidism. Although malnutrition is considered rare in developed countries, research has indicated that there are more than three million people in the UK suffering from or at risk of malnutrition. We present a case of myxoedema coma co-existing with malnutrition.Case report: A 51-year-old Caucasian female presented with acute confusion, peripheral oedema and a bilateral lower limb rash. On exam...

Case: An 81-year-old man with type 2 diabetes, cerebrovascular disease and hypertension presented with a sudden onset of headache. CT scan and MRI scan of the head did not show any significant abnormality. Headache improved spontaneously and he was discharged with no cause for his headache being identified. Four months later he was diagnosed to have pan-anterior hypopituitarism at another hospital and was commenced on appropriate replacement therapy. Serum prolactin was not el...