Endocrine Abstracts

Background: Refractory hypothyroidism poses a clinical dilemma, with great difficulty to treat. Novel cases have targeted intramuscular (IM) levothyroxine (LT4) as a potential treatment for cases resistant to oral LT4. We discuss a patient who became intolerant of IM LT4 after 18 years of treatment, thus SC LT4 was initiated as alternative management.Case Presentation: 35-year-old female with diagnosed Schmidt’s Syn...

Background: Vitamin D is important for calcium homeostasis. In granulomatous diseases including tuberculosis (TB), hypercalcaemia may be seen. Suspected mechanisms include elevated vitamin D sensitivity and increased extrarenal synthesis of 1,25-dihydroxyvitamin D [1,25(OH)2D] by alveolar macrophages within granulomas. Prevalence of hypercalcaemia in TB patients vary worldwide, yet is rare in the UK. We present a case of hypercalcaemia in a patient with TB reactivat...

Background: Pituitary metastasis (PM) is a rare occurrence in malignancy, associated with poor prognosis. Only 7% of patients are symptomatic. High index of suspicion and prompt investigation are essential. We report a case of PM, highlighting challenges in diagnosis and management.Case Report: Sixty-six year old male was referred to endocrinology due to headaches and hyponatremia. He had metastatic colorectal carcinoma, treated with bowel, liver and lun...

Background: Ectopic Cushing’s syndrome (ECS) is a rare and severe condition at times presenting acutely with intense hypercortisolism. The intensity of hypercortisolism can be disproportionate to underlying tumoral condition, and associated life-threatening complications are common arising suddenly. Hypercortisolism must be controlled rapidly pending definitive treatment of tumoral source to avoid life-threatening consequences.Case Summary: 31-year-...

Background: Pituitary metastasis (PM) is a rare occurrence in malignancy, associated with poor prognosis. Only 7% of patients are symptomatic. High index of suspicion and prompt investigation are essential. We report a case of PM, highlighting challenges in diagnosis and management.Case Report: Sixty-six year old male was referred to endocrinology due to headaches and hyponatremia. He had metastatic colorectal carcinoma, treated with bowel, liver and lun...

Introduction: Primary hypothyroidism affects about 3% of the general population in Europe. In most cases, people are treated with Levothyroxine. In relation to the recent British Thyroid Association guidance and the 2020 Competitions and Marketing Authority (CMA) ruling, we examined prescribing data for levothyroxine, NDT and liothyronine by dose, regarding changes from 2016 to 2022.Design: Monthly primary care prescribing data for each British National ...