Endocrine Abstracts

An 88-year old female was referred to the Endocrine clinic for abnormal thyroid function tests. She had been complaining of intermittent palpitations, being generally unwell, with low mood and some degree of weight loss (3 kg within the last 6 months). Her past medical history includes: osteoporosis, atrial fibrillation, poor mobility and falls. There is no family history of thyroid disease. She is currently on Duloxetine, AdCal-D3 and Alendronic acid. On examination, her hear...

Bariatric surgery has emerged as an effective tool for people with severe obesity and type 2 diabetes. A 38 years old lady with type 2 diabetes for 10 years and a BMI of 51 kg/m2, underwent bariatric surgery (Roux-en-Y gastric bypass). Other past medical history includes hypertension and hyperlipidemia. She was diagnosed with gestational diabetes in her 1st pregnancy and type 2 diabetes in subsequent pregnancy. She has lifelong problems with her weight. D...

A 46-year-old woman presented with 2 months history of thirst, polydipsia, polyuria, constipation, three-stone weight loss, and abdominal pain. She had no other significant medical problem except from personality disorder, which was controlled with antipsychotic medications. She denied use of over-counter medications. She had been off lithium for 5 years.On examination, she was dehydrated, tachycardic and appeared anxious. She had palmar erythema, fine t...

Inappropriately raised TSH levels in patients on thyroxine replacement therapy are frequently encountered in clinical practice. Following discussing patient compliance with medication, causes of thyroxine malabsorption including drug interactions, coeliac disease or autoimmune gastritis should be considered. We describe the investigation of a patient with persistently elevated TSH levels in spite of apparently taking adequate thyroxine replacement.Case H...

Background: Literature suggests that whole glucose excursion, rather than plasma glucose concentration at a point, provides more information about glucose tolerance. The glucose area under the curve (AUC) is an index of whole glucose excursion after glucose load. We sought to investigate changes in insulin and glucose homeostasis, including the glucose AUC, 5 years after bariatric surgery.Method: A non-randomised prospective study of 18 participants with...

Background: Bariatric surgery aims to decrease cardiovascular risk factors. The Swedish Obese Subjects study reported that bariatric surgery was associated with reduction in long-term cardiovascular (CV) event. However, uncertainty remains regarding the effect of bariatric surgery on long-term CV risk. One way to predict long-term CV risk after bariatric surgery is to use cardiovascular risk assessment models.Aim: The aim of this study is to investigate ...

Introduction: Endocrine society guidelines advocate early colonoscopy and monitoring for acromegaly-associated complications and recurrence. We aimed to establish whether people with acromegaly under our care received appropriate monitoring.Methods: Patients under follow-up with acromegaly diagnosed 1989-2021 were included. Electronic health records were accessed for clinic letters, colonoscopy reports, blood and imaging results from the diagnosis to rec...

Introduction: Levothyroxine, the standard therapy for hypothyroidism, is usually well tolerated and very few cases of true allergy to levothyroxine have been reported to date. Here we report two cases of rare occurrence of levothyroxine allergy.Case 1: A 56-year-old woman with no previous history of allergies started levothyroxine post-thyroidectomy for Graves’ disease. She developed facial flushing and urticarial rash within 15 minutes of the first...

Introduction: Graves’ disease, a common cause of hyperthyroidism, occasionally poses therapeutic challenges. This case report highlights complexities of Graves’ disease management, particularly an unusual complication: Propylthiouracil (PTU) - induced ANCA vasculitis.Case report: A 51-year-old lady with Graves’ disease diagnosed in 2008, achieved remission with 18 month course of Carbimazole. She experienced a relapse in February 2021 and ...