Endocrine Abstracts

We present the case and management of a 76 year old man who developed medication-related osteonecrosis of the jaw (MRONJ) as a result of 12 years of bisphosphonate and denosumab treatment for hypercalcaemia in the setting of metastatic parathyroid carcinoma.Within two years of his original parathyroidectomy, he had metastatic recurrence diagnosed with progressive hypercalcaemia; imaging revealed three pulmonary nodules consistent w...

We present the case and management of a 76 year old man who developed medication-related osteonecrosis of the jaw (MRONJ) as a result of 12 years of bisphosphonate and denosumab treatment for hypercalcaemia in the setting of metastatic parathyroid carcinoma.Within two years of his original parathyroidectomy, he had metastatic recurrence diagnosed with progressive hypercalcaemia; imaging revealed three pulmonary nodules consistent w...

Rare causes of severe androgen excess (AE) can present a diagnostic challenge to endocrinologists. Imaging may not identify occult ovarian pathology, and the detection of adrenal nodular disease may be indicative of incidental pathology. GnRH analogues can be used both as a medical treatment and as a diagnostic utility to confirm ovarian source, particularly in women with a preferential elevation of serum testosterone (T). In this case series, we present three cases highlighti...

Primary CNS lymphoma (PCNSL) accounts for 0.85% - 2.0% of primary brain tumours. PCNSL arises in periventricular regions of the corpus callosum, with hypothalamic involvement less commonly. While cases have been reported in the literature, cranial diabetes insipidus (CDI) secondary to PCNSL is a rare phenomenon. We present this case series of three patients from our institution diagnosed with CDI and panhypopituitarism in the context of PCNSL.Cases: 1. 3...

Reproductive morbidity is increased in women with diabetes, including a higher prevalence of polycystic ovary syndrome, hypothalamic amenorrhoea and premature ovarian failure. Routine discussion of reproductive and menstrual dysfunction for women with diabetes remains a peripheral feature of clinical consultations. Here we aimed to determine women’s own reproductive care experience. We surveyed women of all ages attending routine diabetes care using a detailed clinical qu...

A 51 year old presented with headaches, fatigue and generalised weakness. She had a background history of hypertension diagnosed one year prior to presentation. Initial laboratory evaluation demonstrated life-threatening hypokalaemia, potassium 0.9mmol/l(R.I. 3.5-5.3). This profound hypokalaemia required ICU admission for replacement of potassium and monitoring. Management of subsequent fluid overload necessitated a brief period of hemofiltration. During the course of evaluati...

Lipodystrophy represents a broad spectrum of disorders, subdivided depending on aetiology (congenital or acquired) or the extent of adipose tissue absence (generalised or partial). A lack of adipose tissue results in systemic insulin resistance and ectopic fat deposition, which predisposes patients to metabolic syndrome and associated conditions such as non-alcoholic fatty liver disease and diabetes mellitus. Additionally, severe hyperinsulinaemia can generate ovarian androgen...

Background: RAI is used as definitive treatment for hyperthyroidism, but administered activities vary between institutions. We used a fixed activity of RAI therapy for Grave’s disease (GD) and toxic multinodular goitre (TMNG), and calculated activity for toxic adenoma (TA). We reviewed treatment outcomes at one year.Methods: Thyroid function tests 1 year post RAI were reviewed retrospectively to asess outcome for 79 hyperthyroid patients divided int...

The thyroid telephone clinic (TTC) was established to facilitate rapid decision making on timing of introducion of anti-thyroidals or L-thyroxine replacement therapy post RAI so avoiding unnecessary outpatient appointments or leaving patients with untreated hyperthyroidism or hypothyroidism. The TTC is also used to monitor TFTs during pregnancy and to dose-titrate treatment of unstable hypo- or hyperthyroid patients. This service is provided to patients who speak English fluen...

Background: Radioiodine (RAI) is widely used for the treatment of hyperthyroidism. Most patients respond to RAI therapy with a normalization of TFTs and improvement in clinical symptoms within 4–8 weeks. Hypothyroidism may occur from 4 weeks on, with 40% of patients being hypothyroid by 8 weeks and >80% by 16 weeks. American thyroid association guidelines recommend testing for free T4, total T3, and TSH within the first 1–2 months after RAI. Biochemical monitorin...