Endocrine Abstracts

A 36-year-old lady presented at 26-weeks gestation with symptoms of palpitations, anxiety, tremors, and breathlessness. She had received the 1st dose of the mRNA vaccine (Pfizer) for Covid-19 a month prior and her symptoms started a couple of weeks after the vaccine. She was a gravida 4 para 2 with gestational diabetes diagnosed during previous pregnancies and also early on in the current pregnancy requiring insulin treatment maintaining excellent antenatal glycaemic control. ...

Introduction: Evidence suggests that ionised calcium (iCa) and not total calcium is the physiologically relevant blood calcium component. Most blood gas (BG) analysers calculate iCa, but this is often ignored. We report our findings from a retrospective audit in medical in-patients and the potential benefit of this underused resource.Methods: A retrospective audit of admissions to two general medical/endocrine wards during January and February 2016. Data...

Background: Adult spontaneous hypoglycaemia in non-diabetic patients is not a diagnosis per se but a manifestation of a disease and is often a diagnostic challenge. Although rare, it’s important to exclude endogenous hyperinsulinemia, because treatment can be curative. The aim of our audit was to assess the usefulness of various investigations done for spontaneous hypoglycaemia in diagnosing Insulinoma.Methods: Data on 98 non-diabetic patie...

Aim: Hyperthyroidism can affect pregnancy outcomes based on activity of the disease, ongoing use of anti-thyroid drugs (ATD) and TSH receptor antibody (TRAB) positivity. The aim of our audit was to analyse the outcomes of fetal monitoring in pregnant women with previous or current history of active hyperthyroidismMethods: The data on all patients with hyperthyroidism and pregnancy over 3 years was collected. The local guidelines recommend TRAB check at 2...

Background: Testosterone deficiency (TD) affects 5–6% of men aged 30–79 years and it can be a presenting feature of a serious underlying condition like a pituitary tumour. Clinical practice guidelines have recommended thorough investigative workup of such patients to delineate the underlying pathology in patients with secondary TD. We have undertaken a retrospective study to assess the need for expensive investigations in patients with relatively mild TD suspected to...

Objectives: Transient thyroid hypofunction during the initial 3 months following radioiodine (RAI) therapy is well recognised with a reported incidence of 10–15%. There are no clear diagnostic criteria, often leading to management uncertainty, inappropriate diagnosis of ‘cure’ and institution of life-long thyroxine therapy. The aim of our audit was to assess the incidence and identify predictors for transient euthyroidism or hypothyroidism following administrati...

A 72-year-old gentleman was diagnosed with primary hyperparathyroidism in 2005. He had 6 admissions in a year with hypercalcaemia refractory to treatment with conventional agents. On each admission he was treated with intravenous pamidronate and fluid resuscitation. This resulted in an average stay of 16 days and an average cost of £4800 per admission.A single parathyroid adenoma was diagnosed on sestambiscan. He was not considered fit for surgery d...

Background/Aim: Radioactive-iodine (RAI) therapy aims to cure hyperthyroidism, with some International authorities recommending a sufficient RAI dose to render patients hypothyroid. An audit on low dose RAI (<400 MBq) at our University Hospital in 2014 suggested above national average rates of Thyrotoxicosis relapse (24%) and lower rates of hypothyroidism (41%) 6-months post RAI. From 2015, a fixed dose (555 MBq) RAI was utilised and we present the audit outcomes using thi...

Introduction: Non-functioning pituitary macroadenoma (NFMA) can cause considerable morbidity due to pituitary dysfunction and pressure effects. We present recent experience in managing cases diagnosed with NFMA at a single tertiary centre between January 2009 and October 2013.Results: Of the 63 patients with NFMA, 28 (44%) were females. Age ranged from 22 to 91 (mean 63). Visual disturbance symptoms (35/63; 57%) were the commonest presentation. Headache ...

Background: Short Synacthen test (SST) is being increasingly used in various clinical conditions, mainly for completion purpose of ruling out adrenocortical insufficiency rather than actively suspecting it (for instance hypothyroidism with tiredness, type 1 diabetes with hypoglycaemia). The aim of our retrospective analysis was to assess if a random cortisol could predict the outcome of SST.Method: Data were collected on all SST done at the endocrine uni...