Endocrine Abstracts

Background: Demeclocycline is a well-known treatment for syndrome of inappropriate ADH secretion (SIADH). We studied the use of demeclocycline for treatment of SIADH in our hospital to assess its efficacy and safety.Materials and methods: A search was performed for all discharge summaries containing demeclocycline over period of 1 year. 40 results obtained of which five were excluded as demeclocycline was mentioned but not actually used. 35 admission epi...

Background: It is well documented that some patients with hypothyroidism continue to be symptomatic despite normalisation of TSH levels with T4 mono-therapy. The Royal College of Physicians 2008 statement recommends that T4 alone should be used for the treatment of hypothyroidism with no recommendation for additional T3 therapy. However, the Internet has many reports of symptomatic benefit on combination therapy and patients may present to the outpatient clinic requesting T3 t...

A 77-year-old lady presented with reduced conscious state, dysphasia and profound confusion on a background of behavioural change and anorexia over the previous 10 days. She was previously independent with history of hypertension controlled on atenolol (100 mg). She was significantly hypertensive 200/100. Her serum calcium was elevated at 4.01 mmol/l (2.05–2.60). The serum parathyroid hormone (PTH) was also significantly elevated at 26 pmol/l (0.5–6.4) consistent wit...

Background: Postprandial hyperinsulinemic hypoglycaemia due to nesidioblastosis is a significant and debilitating complication after Roux-en-Y gastric bypass surgery (RYGB). There is growing evidence suggesting this is due to increased incretin hormones secretion. Nesidioblastosis can be difficult to manage with variable response to different pharmacological therapies and some requiring partial/total pancreatectomy or revision of bypass surgery pouch. We present a patient who ...

We present a case of 76-year-old male who attended acute medical unit with 3 week history of confusion, slurred speech and reduced mobility. One month prior to his admission he was diagnosed with severe hypothyroidism with TSH of 100 mU/l and T4 of 1.9 pmol/l and significantly positive anti-peroxidase antibodies (561 IU/ml) and was started on 100 μg of levothyroxine by his GP. During his admission his confusion persisted despite antibiotics for presumed chest i...

BackgroundPancytopenia due to hypopituitarism has been reported previously in the literature. Most of these case reports relate to hypopituitarism secondary to Sheehan’s syndrome. We report a case of isolated ACTH deficiency causing pancytopenia which was successfully treated with hydrocortisone replacement.Case history: A 71-year-old lady with a known history of treated hypothyroidism and learning disabilities was referred to...

We describe our patient, a 50 year old lady who developed Addisons disease 10 years ago with typical signs and symptoms of weight loss, hyperpigmentation, tiredness and postural hypotension. She is under follow up at our clinic for last 4 years. Her identical twin was diagnosed with Addisons disease and hypothyroidism at age 27 and with Coeliac disease when she was 43. Both of them are positive for anti-adrenal and TPO antibodies.Our patient developed le...