Endocrine Abstracts

Introduction: Infertility affects 15% of couples and a male factor accounts for 50% of cases. Adequate history taking, examination of both partners, hormone testing and semen analysis are required to ascertain a cause and treatment strategy. Gonadotropin therapy with Human Chorionic Gonadotropin (HCG) and recombinant Follicle Stimulating Hormone (rFSH) is indicated for use in men with reduced spermatogenesis due to hypogonadotropic hypogonadism (HH). We pres...

Introduction: Infertility affects 15% of couples and a male factor accounts for 50% of cases. Adequate history taking, examination of both partners, hormone testing and semen analysis are required to ascertain a cause and treatment strategy. Gonadotropin therapy with Human Chorionic Gonadotropin (HCG) and recombinant Follicle Stimulating Hormone (rFSH) is indicated for use in men with reduced spermatogenesis due to hypogonadotropic hypogonadism (HH). We pres...

Introduction: Icodextrin is a large molecular weight glucose polymer used in the diasylate called Extraneal. It is hydrolysed to oligosaccharides, which are read as glucose by some blood glucose monitoring (BGM) devices resulting in overestimation of capillary blood glucose (CBG) readings. This is dangerous for patients on ambulatory dialysis trying to achieve optimum diabetes control.Case: A lady with type 1 diabetes using an insulin pump for diabetes c...

Introduction: Patients with life-threatening inborn errors of metabolism are usually managed at specialist care centres. These patients are living longer and some of them have migrated to areas far from their specialist care centres. We present two such cases.Case 1: A 37 year old female with Ornithine Transcarbamylase Deficiency (OTCD), well-managed at a specialist care centre since childhood, relocated a few times before settling down in our area. OTCD...

Introduction: There are reports of patients having co-existing primary hyperparathyroidism and familial hypocalciuric hypercalcaemia (FHH). The combination of relative hypocalciuria, hypercalcaemia and slightly elevated serum parathyroid hormone (PTH) could indicate FHH. Medications such as, lithium and bendroflumethiazide can reduce renal excretion of calcium. We report a case highlighting the importance of being aware of drug-induced hypocalciuria during the investigation of...

Introduction: Prolonged therapy (≥ 3 months) with high-dose corticosteroids (≥ 7.5 mg Prednisolone or 1–1.5 mg Dexamethasone daily) can result in adrenal atrophy and secondary adrenal failure. Abrupt withdrawal of corticosteroids after prolonged use can lead to adrenal insufficiency, corticosteroid withdrawal symptoms or a relapse of the initial disease. A safe flexible management plan is required for each patient. We illustrate with two cases.<p class="ab...

Introduction: Vasopression-2 receptor antagonists (VPAs) have been licensed for the treatment of hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH). As usage extends to other causes of hyponatraemia, over-rapid correction and hypernatraemia remains as important side-effect. We present a patient with severe SIADH highlighting the need for guidance and vigilance when using these potent drugs.Case: A 82-year-old lady...

Introduction: Myxodedema coma comprises a complex endocrinological emergency whereby there is severe clinical hypothyroid state. It is a life threatening yet a potentially reversible condition that may prove rather difficult to recognise due to the complex symptomatology. Very few articles report the specific therapy for myxoedema coma.The case: Here we present an elderly lady with previous total thyroidectomy, who despite receiving oral thyroxin tablets...

Introduction: Radioiodine is used for the treatment of Thyrotoxicosis when medical treatment (anti-thyroid drugs) has failed or cannot be tolerated and surgical treatment is not an option. We aimed to assess our compliance with the Royal College of Physicians (RCP) guidelines for Radioiodine treatment, and assess patient satisfaction with our Radioiodine service.Methods: Notes for patients who received Radioiodine treatment between January 2010 and April...

Background: Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is an autosomal recessive inherited disorder resulting in the inability to breakdown medium-chain fatty acids to provide energy during periods of low-calorie intake and hypoglycaemia (infections, fasting, vomiting). Without urgent treatment, the accumulation of toxic fatty acids leads to encephalopathy and sudden death.Pregnant females with Type 1 diabetes requ...