Endocrine Abstracts

Background: Subclinical hyperthyroidism provides a challenging condition in clinical endocrinology. The debate about who and when to treat has long been discussed. Despite guidelines describing assessment of such patients, there is surprising little data on imaging in this condition and the role of nuclear medicine or ultrasound scans.Aim: To review all patients with subclinical hyperthyroidism referred for imaging studies at a district general hospital ...

Denosumab is a MAB currently licensed for use in treatment of osteoporosis. It is designed to inhibit RANK ligand to prevent bone breakdown by osteoclasts. Its use for treatment of malignant hypercalcaemia is still to be fully investigated.We present the case of a 71-year-old south Asian gentleman with recurrent resistant hypercalcaemia secondary to follicular non-Hodgkin’s lymphoma. Calcitriol levels were elevated which was thought to be lymphoma r...

A 20 year old female with a 3 year history of type 1 diabetes presented to the emergency department unresponsive and was diagnosed with severe diabetic ketoacidosis (DKA). She had no other past medical history and was on a basal bolus regime of insulin only. GCS was 7, pH 6.7, HCO3 3.5 mmol/l, ketones 3+ on urinalysis and blood glucose of 43 mmol/l.She was commenced on fixed rate insulin infusion and IV fluids however also noted to have unequal pupils. S...

An 18-year-old female presented to acute services with polydipsia and lower back pain. Routine blood tests revealed hypercalcaemia 3.67 mmol/l with significantly raised parathyroid hormone levels 2986 ng/l (10–65), alkaline phosphatase (ALP) 3330 IU/l (30–130), and low vitamin D 10.3 nmol/l (50–220). A CT scan revealed a 3.5 cm parathyroid adenoma and very osteopenic bones with multiple lucencies in keeping with primary hyperparathyoidism. The parathyroid subtra...

A 51-year-old Afro-Caribbean lady with a history of primary hyperparathyroidism, type 2 diabetes and hypertension was admitted with confusion. Her medication at the time included five anti-hypertensives.She was treated for an infection but despite a long course of antibiotics she remained confused with visual hallucinations and aggression.She was noted to have resistant hypertension with systolic blood pressures over 220 mmHg and p...

42 insulin related incidents were reported within our Trust in 2014. Subsequent Root Cause Analysis revealed numerous insulin errors, hyperglycemia mismanagement and highlighted significant deficits in diabetes knowledge amongst nursing staff. To address the above issues, new safety interventions were introduced and five key outcomes are:1. A new stand-alone insulin prescription chart introduced May’15 has seen insulin incidents dec...