Endocrine Abstracts

Introduction: Parathyroid cancer is a rare endocrine malignancy and constitutes 0.005% of all cancers. It can recur in 50% of cases. The first recurrence commonly occurs within 3 years of the original diagnosis. Hypercalcaemia is the main cause of morbidity and mortality. We present a case of a 62-year-old male patient who had an atypical lung nodule recurrence with normal calcium and PTH levels, six years following resection of a functioning parathyroid cancer.<p class="a...

Introduction: Pathological fractures are uncommon in young patients and raise concern about malignancy. Brown tumour (osteitis fibrosa cystica) is a rare benign resorptive bone lesion reported in approximately 3% of patients with primary hyperparathyroidism (PHPT). These have become uncommon in contemporary practice and have the potential to be misdiagnosed because of radiological similarities to other bone diseases especially malignancy.We present a case where the first prese...

Background: Treating life-threatening diabetic ketoacidosis (DKA) with a pH of <6.9 is extremely challenging and often refractory to treatment using standard fixed dose insulin DKA management protocols which may not work effectively at this low pH because of increased insulin resistance. I.v. bicarbonate (HCO3) use in this situation can be considered but remains controversial due to the risk of significant side effects as well as limited evidence in literature. ...

Background: The short- and long-term clinical outcome of patients receiving radioactive iodine treatment (RAI) differs in various studies. There is little consensus regarding the most appropriate dose of RAI to be administered. The range of activities currently prescribed varies between 200 and 800 MBq, with majority of patients receiving 400–600 MBq. In our centre, all patients receive a standard fixed dose of 400 MBq.Aim: To assess the cure rate w...

Cerebral salt wasting (CSW) occurs as the result of injury to the central nervous system and is most commonly found among those who have experienced a traumatic brain injury (TBI). Although incidence is varied, it has been reported to be as high as 30% within the patient population presenting to hospital with a TBI. CSW causes hyponatremia with concurrent hypovolemia and increased sodium within urine despite normal renal function. Because of its rare nature, CSW is often misdi...

Background: Central hypothyroidism can be difficult to diagnose as TSH values often reside within the normal range. The Endocrine Society clinical guideline for hormone replacement in hypopituitarism suggests levothyroxine is indicated for treatment of secondary hypothyroidism where fT4 levels decrease by ≥20%. To determine the reliability of this biochemical marker of secondary hypothyroidism we evaluated evolution of TFTs over time within a cohort of NFPA.<p class=...

Introduction: Prolonged therapy with high-dose corticosteroids (≥ 7.5 mg Prednisolone or 1–1.5 mg Dexamethasone daily) can result in adrenal atrophy and hypofunction. Abrupt withdrawal of corticosteroids after prolonged use can lead to adrenal insufficiency, corticosteroid withdrawal symptoms or a relapse of the initial disease. There are several in-house protocols for safe corticosteroid dose tapering but a national protocol is required.Our p...

Introduction: Insulinoma a neuroendocrine tumour is diagnosed by inappropriately raised Insulin concentrations during a spontaneous or induced episode of hypoglycaemia. A provocative 72-h supervised fast is done to evaluate suspected inappropriate insulin secretion. Our aim is to see if it is feasible for a shorter duration of fast is enough to confirm Insulinoma.Method and results: In our Trust we analysed retrospectively in the last 10 years, ...

Introduction: Hyponatraemia following surgery is usually due to a mismatch between fluid input and output peri- and post-operatively. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is another important cause of hyponatraemia, commonest cause being medications, and intrathoracic and intracranial infections and neoplasia. SIADH has been reported to occur after pituitary surgery but rarely after other types of surgery. We present a severe case of SIADH-related h...

Background: Antithyroid drugs (ATDs) are preferred as a first-line treatment for Graves’ disease (GD). However, around 50–60% of patients relapse following treatment withdrawal. Radioactive iodine (RAI) or thyroidectomy is recommended for these patients, however, repeat ATD therapy is a further option, dependent upon patient choice. The long-term efficacy of ATD in relapsed GD has not been robustly established.Methods: We conducted a retrospect...