Endocrine Abstracts

Background: Primary Hyperparathyroidism is a leading cause of hypercalcaemia and is frequently asymptomatic. Due to its long-term complications, early diagnosis and management is essential. NICE published guidelines on diagnosis and management of Primary Hyperparathyroidism in May 2019. The aim of this audit was to compare our existing practices against NICE guidance.Methods: We conducted retrospective data collection by identifying patients diagnosed wi...

We present a case of a 79 year old gentleman who attended the emergency department with a one day history of acute confusion and hallucinations. His background included trans-sphenoidal surgery for a gonadotrophic pituitary macro-adenoma in 2012 with subsequent panhypopituitarism and post-operative diabetes insipidus. He also had a history of restless-leg-syndrome for which he took Amitriptyline chronically, COPD and tablet-controlled diabetes mellitus. Of significant note, th...

A 64 year old female with a background history of hypertension resistant to dual therapy had recurrent admissions to the local emergency department with pulmonary oedema and chest tightness over the preceding 3 months associated with fluctuations in Troponin I levels. This led to multiple cardiac investigations including invasive coronary angiogram which did not report any abnormality. Her blood pressure was elevated at 200/120 mmHg and an electrocardiogram demonstrated sinus ...

An 87-year-old lady was admitted to hospital with severe unexplained hypoglycaemia with capillary glucose of 1.8 mmol/l and went on develop recurrent episodes of symptomatic hypoglycaemia during this admission. She had a background history of diabetes mellitus, well under controlled with diet and a previous diagnosis of solitary fibrous pleural tumour of left lung, which was resected completely in 2013 but reoccurred in 2022 with left sided pleural effusion. Her liver and rena...

An 87-year-old lady was admitted to hospital with severe unexplained hypoglycaemia with capillary glucose of 1.8 mmol/l and went on develop recurrent episodes of symptomatic hypoglycaemia during this admission. She had a background history of diabetes mellitus, well under controlled with diet and a previous diagnosis of solitary fibrous pleural tumour of left lung, which was resected completely in 2013 but reoccurred in 2022 with left sided pleural effusion. Her liver and rena...

An elective total thyroidectomy was performed on a previously well 45-year-old nurse for toxic multinodular goitre. The operation was uneventful and the patient was discharged. She was re-admitted two days after the operation, with paraesthesia and muscle spasms affecting the face and hands. She was found to be hypocalcaemic, corrected calcium 1.83 mmol/l. She was treated with intravenous calcium gluconate, oral calcium and 1-alpha calcidol. Parathyroid levels were undetectabl...

Background: Empty Sella syndrome (ESS) is caused by the herniation of the subarachnoid space into the sella turcica, causing compression of the pituitary gland. Patients may be asymptomatic or exhibit different degrees of pituitary hormone deficiency. Pan-hypopituitarism can occur if there is decreased or absent secretion of all of the anterior pituitary hormones. Case: We report the case of a 68 year old female of Pakistani background who was visiting t...

A 44 years old lady was reviewed by endocrinology team in January 2020 for weight gain, increased fat deposition around the neck, constant fatigue and decreased libido. She denied usage of exogenous steroids. She was normal BMI, normotensive and did not display signs of Cushing’s syndrome in first visit. Although overnight dexamethasone suppression was failed to suppress: cortisol of 141 nmol/l and ACTH 78 ng/l, Low dose dexamethasone suppression test (LDSST) was adequate...

Aim: A QIP to improve early recognition and treatment of adrenal crisis (AC) in adults. Issuance of new NHS emergency steroid cards (SEC) in accordance with National Patient Safety Alert (NPSA) August 2020.Background: National Reporting and Learning System found that two deaths and six incidents (severe harm) were associated with shortfalls in managing adrenal insufficiency (AI) over 4 Years. A resulting NPSA advised the care organisations to identify th...

Isolated Central Diabetes Insipidus is a rare condition characterised by deficiency of arginine vasopressin (AVP) which presents with polyuria and polydipsia. The reported prevalence of diabetes insipidus is 1 in 25,000. The pathogenesis of central diabetes insipidus is often uncertain however the known causes can be divided into acquired, through trauma or vascular injury as well as infiltrative including malignancy, and congenital abnormalities which accounts for less than 1...