Endocrine Abstracts

Neuroleptic-induced hyperprolactinaemia (NIHP) is a recognised complication of neuroleptic drug therapy.Pituitary tumours however may exist co-incidentally in patients on neuroleptic medications and contribute to hyperprolactinaemia. A potential pitfall is to attribute the elevated prolactin level to drug therapy alone particularly when treatment with neuroleptics has been longstanding.A 35 year old woman with bipolar affective disorder was referred with...

Secondary causes of diabetes are uncommon. As 50-80% of patients with diabetes have co-existing hypertension, a high index of suspicion is required to exclude a secondary cause in patients presenting with both conditions. Atypical presentations may delay the diagnosis.A 49 year old man presented with a one year history of polydipsia, polyuria and fatigue. Diabetes was diagnosed with a random blood glucose (RBG) of 12 mmol/l. Hypertension diagnosed 15 yea...

Primary adrenal tumours are responsible for about 10% of cases of Cushing's syndrome. Adrenocortical carcinomas are rare with an incidence of 2 per million per year. Both adrenocortical adenomas and carcinomas occur more commonly in women.A 46 year old previously fit woman presented with a short history of hirsutism, facial plethora, amenorrhoea, acne and progressive weight gain. Hypertension and glucose intolerance had been diagnosed recently. There was...

Cranial diabetes mellitus is not usually associated with microprolactinomas. We report a 29 year old lady who presented 8 months after the birth of her only child with a 4 month history of polyurea and polydipsia. She had also noticed galactorrhoea and decreased libido although she had never breastfed the child and had not resumed normal menstrual function. The birth of her child was normal and uncomplicated although she admitted to being stressed recently since the baby was h...

Introduction:Amiodarone is a life saving anti arrhythmic drug,but it has a complex side effect profile involving organs that include thyroid,lungs, liver and eyes. It is well known that patients on long term amiodarone therapy should be followed up in a structured manner including regular thyroid function tests,liver function tests,chest xray and eye examination.There are guidelines suggested by the Summary of Product Characteristics (SPC) for amiodarone...

Background: The absorption kinetics of soluble insulin are complex. Soluble insulin is absorbed after a delay as the hexameric form dissociates before being absorbed as the dimer.Patients using soluble insulin are instructed to inject 15-30 minutes before meals.In practice few patients comply with these recommendations.The aims of this study were to identify the proportion of patients injecting at the recommended time and to assess any association between injection timing and ...

Hyperthyroidism is diagnosed in pregnancy in about 0.1 - 0.4% of patients. Graves' disease is the commonest cause of thyrotoxicosis in pregnant women. The natural course of Graves' disease in pregnancy is characterised by an exacerbation of symptoms in the first trimester and during the post partum period. Symptoms usually tend to improve in the second half of pregnancy.We describe a patient who was diagnosed with Graves' disease in the third trimester of pregnancy. A 32 y...

Introduction: Thyroid eye disease affects an estimated 400,000 people in the UK and for a sizeable minority this is an extremely unpleasant condition. Radioactive iodine treatment with I131 for thyrotoxicosis can cause sight-threatening flare-up of dysthyroid eye disease. Patients with dysthyroid eye signs should undergo specialist ophthalmology assessment prior to administration of I131.Case history: A 56 year old gentleman presented with symptoms of th...

The porphyrias encompass a group of disorders characterized by inherited or acquired derangements in the biosynthesis of heme.Porphyria cutanea tarda is the most common form and is characterized by chronic skin lesions and hepatic disease.It may rarely be complicated by hepatocellular carcinoma. We present a 67 year old man who presented with hepatocellular carcinoma on a background of previous porphyria cutanea tarda.The patient was diagnosed with Type ...

Introduction: Several biomarkers are elevated in late pregnancy in women with preeclampsia (PET), but none have been sensitive or specific enough to be used routinely in early pregnancy to predict the condition. We measured plasma levels of the anti-angiogenic peptides FMS-like tyrosine kinase 1 (sFLT-1), soluble endoglin (sENG), placental growth-factor (PGF), and an array of cytokines and adhesion molecules in early and mid pregnancy to assess their ability to predict PET.</p...