Endocrine Abstracts

Incidence of Type II Diabetes Mellitus (T2DM) is increasing; majority of which is managed in primary care. NICE recommends starting Metformin as a first-line therapy. Studies have linked Metformin use with Vitamin B12 deficiency and suggest that regular monitoring of levels is warranted. The pathogenesis is not fully understood. Literature suggests that the risk of developing B12 deficiency is greatly influenced by high doses and long duration of therapy. An audit was conducte...

Annexin 1 (ANXA1, lipocortin 1), a Ca2+ and phospholipid binding protein, is a strong candidate mediator of the interplay between the immune and neuroendocrine systems. Within the neuroendocrine system ANXA1 is expressed in abundance by the non-secretory pituitary folliculo-stellate (FS) cells (1), which show characteristics of resident microglia. We have previously reported that IL-6 up-regulates ANXA1 expression in the liver in vivo and in A549 cells (lung epithelial...

Background: Managing mental health patients with Diabetes Mellitus can be challenging. Patients with mental health problems are poorly compliant with both antipsychotic and diabetes treatment. Literature has suggested that some psychiatric illnesses can be independent risk factors for diabetes. Furthermore, diabetic patients have a higher incidence of psychiatric disorders. There is a causal relationship between newer antipsychotic medications and metabolic abnormalities.<...

Background: Spontaneous coronary artery dissection (SCAD) is a rare condition, which is sometimes underdiagnosed in patients with chest pain and presumably normal coronaries. There have been a few case reports of patients with thyroid dysfunction and arterial dissections.Case: We present a 20 year old female with recent diagnosis of Graves’ thyrotoxicosis managed with methimazole. She initially presented in South Korea with shortness of breath on ex...

Aim: To evaluate the feasibility of non-face to face (NFTF) contact in the follow-up for patients with thyrotoxicosis on carbimazole therapy.Background: While on carbimazole, achievement of a euthyroid state may involve multiple clinic appointments. We hypothesize by conducting these appointments in a NFTF setting, i.e. telephone consultation with trained nurse practitioner supported by an Endocrine consultant; a higher volume of consultations can occur ...

Introduction: Hypercalcaemia is a commonly encountered biochemical abnormality. The most common causes of hypercalcaemia are primary hyperparathyroidism and malignancy. Familial Hypocalciuric Hypercalcaemia (FHH) is a rare cause of hypercalcaemia.Case: We present a 53-year-old female, who was referred to the endocrinology clinic for further investigation of a persistent hypercalcaemia associated with low-to-normal parathyroid hormone level (1.5pmol/l). S...

Annexin 1 (ANXA1), a Ca2+ and phospholipid binding protein, is an important mediator of glucocorticoid (GC) action in the host defence and neuroendocrine systems (1). It is not however known whether the dysregulation of the inflammatory response sometimes observed in patients with disturbances in GC secretion is associated with alterations in PBL ANXA1 expression/activity. To address this question we have (a) examined ANXA1 expression (flow cytometry and western blot analysis)...

Hypokalemia is a common and potentially fatal electrolyte disturbance, especially in hospitalised patients. Therefore, prompt assessment and management is vital to avoid serious complications. We report a case of 77 Year old gentleman with a background of Alzheimer’s presenting with abdominal distension, intermittent diarrhoea and shortness of breath. He had normal blood pressure with no signs of Cushing syndrome but was found to have hypokalaemia. Plain imaging revealed ...

Traditionally, patients diagnosed with primary hyperparathyroidism present with mild hypercalcaemia and tend to be asymptomatic. Symptomatic patients tend to have severely high calcium and exhibit the classic ’bones, stones, abdominal moans and psychic groans.’ We present a case of a 92-year-old Caucasian gentleman presenting with recurrent falls, postural hypotension and trauma to head and shoulder. X-ray imaging showed small non-specific lucencies in the cervical a...

Bilateral adrenal haemorrhage is an uncommon but life-threatening condition which may result from trauma, sepsis, coagulopathy, underlying tumour or autoimmune conditions. We present a 62-year-old female with a history of well controlled hypertension and asthma who was admitted with sudden onset epigastric pain and suspected cholecystitis. She received her first dose of Astrazeneca (AZ) Covid-19 vaccine seven days prior to onset of symptoms. Her systolic blood pressure was mor...