Endocrine Abstracts

This 42-year-old male presented with a six-month history of general lethargy and mood changes. He had experienced weakness & difficulty climbing stairs; weight loss; ankle swelling and increased frequency of micturition. There was no significant past medical history.Initial investigations revealed Na+ 144mmol/L (135-145);K+ 2.3mmol/L(3.5-5.2); U 8.8mmol/L (2.6-6.7); Cr 75μmol/L (60-125); TCO2 41mmol/L (21-31); Fasting glucose 7.4mmol/L; TSH 0.21mU...

This 42-year-old male presented with a six-month history of general lethargy and mood changes. He had experienced weakness & difficulty climbing stairs; weight loss; ankle swelling and increased frequency of micturition. There was no significant past medical history.Initial investigations revealed Na+ 144mmol/L (135-145);K+ 2.3mmol/L(3.5-5.2); U 8.8mmol/L (2.6-6.7); Cr 75μmol/L (60-125); TCO2 41mmol/L (21-31); Fasting glucose 7.4mmol/L; TSH 0.21mU...

A 36 year old lady presented with a 6 month history of amenorrhoea & increasing fatigue. There was no background of headaches or visual disturbance. She denied thyroid related symptoms. Examination revealed her to be both pale and fatigued however there were no other significant findings. Investigations revealed: random cortisol 56 nmol/l; prolactin 1698mU/l (0-480); LH 0.3U/l; FSH 2.9U/l; fT4 <5pmol/l (10-24); TSH 21.92mU/l (0.4-4.0); IGF1 12.5nmol/l (10-24) An insulin...

Introduction: A 59-year-old gentleman with longstanding poorly controlled type 2 diabetes mellitus, obesity, hypertension, obstructive sleep apnoea, depression and type 2 respiratory failure was seen in diabetes review clinic and noted to have truncal obesity, moon facies and wasting of the proximal muscles.Investigations: Urinary free cortisol was 782 nmol/24 h (NR <200). Midnight cortisol was 595 and 532 nmol/l on consecutive days. After low dose d...

Armour thyroid (Armour) is unlicensed in the UK for the treatment of hypothyroidism. It is natural porcine-derived thyroid replacement with 1 grain containing 38 mcg levothyroxine (T4) and 9 mcg L-triiodothyronine (T3), and unspecified amounts of T1, T2 and calcitonin. We have used Armour as a third line agent in selected patients who have not responded adequately to T4 monotherapy, and combination T4/T3 therapy since 2003.Aim: To assess c...

A 64-year-old man presented with mild biochemical hyperthyroidism – TSH <0.01 mU/l (NR 0.35–4.90), FT4 19.4 pmol/l (NR 9–19) in 2005. He was treated by his general practitioner with a 9 months course of carbimazole. Six months later, TSH became suppressed (0.05 mU/l) but with a normal fT4 (17 pmol/l). He was referred to a ‘One-Stop’ Thyroid Clinic and was seen there 3 months later. Thyroid isotope scan showed a toxic multinodular goitre. He was tre...

A 72 years old lady was referred to endocrine clinic with raised serum calcium of 2.69 mmol/l and PTH of 99.6 ng/l (3.0–48.0 ng/l) detected during investigations for an abnormal skeletal survey. She was known to have osteoporosis from the age of 59 diagnosed on Dexa scan. Case notes revealed raised serum calcium of 2.52–2.60 mmol/l since year 2000. Her repeat serum calcium was 2.77 mmol/l with phosphate of 1.03 mmol/l and 25 hydroxy vitamin D of 36 nmol/l. She admitt...

This 48-year-old with consanguineous parentage presented at the age of 23 in 1980 with congenital bilateral sensorineural deafness and hypothyroidism requiring replacement with 150 mcg thyroxine. There was a family history of deafness and thyroid disease. A perchlorate discharge test was performed and 42% of the radioiodine within the gland was discharged by potassium perchlorate (NR <10%).Over the following decade she developed a diffuse goitre whic...