Endocrine Abstracts

A 17-year-old young lady presented with tiredness, weight loss, palpitations, hot flushes and irregular menstruation in April 2016 and her initial TFTs showed TSH <0.03 mU/l with a fT4 of 48.2 pmol/l. She was treated with carbimazole 40 mg daily and further investigation confirmed she had had Graves’ disease as TSH receptor antibodies (2.10 U/l), TPO antibodies (>1300 IU/ml), thyroid ultrasound scan demonstrated mildly enlarged and thyroiditis. She had only six period...

A 41-year old lady with hypothyroidism for 20 years attended the endocrinology clinic for persistently raised TSH levels despite high dose levothyroxine. Past medical problems – depression, psoriasis, obesity, cholecystectomy. Her hypothyroidism was well-controlled until 2016 but since then, her TSH concentration had risen significantly to >100 mU/l with normal free T4. Levothyroxine had been increased in steps to 200 mcg/day. Despite the increased dose, the TSH concentra...

A 48-year-old gentleman, father of 3 children, was referred to our endocrinology clinic, with sexual dysfunction and hypergonadotrophic hypogonadism. He had a history of severe Coronovirus-Disease-2019(COVID-19) pneumonitis for which he received prolonged ventilatory support. Post extubation, he experienced testicular pain and swelling. A testicular ultrasound showed a left-sided hydrocele, multiloculated epididymal-cyst and a right testicular cyst. He also described new sympt...

Our endocrinology department had been looking after a patient with Graves’ disease since 2007. At this time, she was 17 years old (TSH <0.03 mIU/l, T4 62.6 pmol/l). Carbimazole was prescribed but she was non-compliant with medications and clinic appointments. Her background history included DiGeorge Syndrome (22q11 deletion) manifesting with a bicuspid aortic valve, primary hypoparathyroidism and chronic constipation. She was seen in October 2011 and carbimazole incre...

Case history: A 53-year-old woman presented with vasculitic rash affecting her limbs. She has a 3-year history of thyrotoxicosis. Having developed intolerance to carbimazole she was maintained on propylthiouracil (PTU) for the last two years. Imaging results were consistent with multinodular goitre. Thyroid stimulating immunoglobulin was negative. A few months prior to this presentation she developed dysphagia. Repeat imaging showed an 8 cm right thyroid nodule that grew signi...

A 19-year-old gentleman, with Coffin-Siris-Syndrome(CSS)(ARID1B:c.6157dup gene-mutation), was referred to our endocrinology clinic, with rapid weight-gain and recent onset of Type-2-Diabetes. He was of short stature, he had central-adiposity, facial plethora, proximal myopathy and gynaecomastia. Endocrine testing revealed ACTH:61ng/l, Cortisol:772nmol/l, Total-Testosterone:2.8nmol/l, FSH:6.3U/l, LH:2.2U/l, Prolactin:87mU/l, IGF-1:61ug/l, TSH:0.18mU/l, T4:10.3 pmol/l, HbA1C:84m...