Endocrine Abstracts

Background: Hypoglycaemia is rare in people without diabetes. Certain medications are known to cause hypoglycaemia in non-diabetic patients.Case details: A 65-year-old man with background congestive cardiac failure, previous pulmonary TB (1997), bronchiectasis and pulmonary fibrosis (long-term oxygen therapy) was admitted for exacerbation of bronchiectasis. He completed a course of antibiotics and steroid treatment. While awaiting discharge, he had two e...

Case-1: Nineteen years old nursing student with primary hypothyroidism, despite thyroxine (T4) at 200 μg/day and subsequent trial of T4+T3, remained significantly symptomatically hypothyroid. Over 4 years worsening hypothyroidism was evident (TSH: 19.1 to >200 and fT4 2.1–6.8) despite dose/regime changes. Investigations for malabsorption: normal coeliac screen, B12, ferritin, FBC, kidney and liver function, autoimmune p...

Introduction: 3-β-hydroxysteroid dehydrogenase (3BHSD) deficiency is a rare genetic disorder of steroid biosynthesis that results in decreased production of all three groups of adrenal steroids, which include mineralocorticoids, glucocorticoids, and sex steroids.Case presentation: An infant was born with ambiguous genitalia in 1975 to a conservative Muslim family and was registered as male. The child was hospitalised with addisonian crisis on the el...

Case history: A 51-year-old lady with a background of classical migraine and amenorrhoea conceived successfully via IVF, without prior endocrine assessment. Symptoms during the third trimester of pregnancy led to the diagnosis of a pituitary mass lesion (see Table). Possible differential diagnoses, on subsequent endocrine review, included macroprolactinoma, microprolactinoma with expansion during pregnancy, or lymphocytic hypophysitis.After 6 years of do...

Background and case: A 38-year-old man presented acutely with left-sided retro-orbital pain, a heavy/numb sensation in his left arm and blurred vision and diplopia on left lateral gaze. Baseline biochemistry, liver function and haematology were normal. His TSH was 3.9 (0.3–4 mU/l) and CRP 92 mg/l (<10). Plain CT head was unremarkable as was the MRI as reported, and atypical migraine was suspected. Vertical diplopia on left lateral gaze and left upper arm paraesthesia ...

Background and aims: Thiazolidinediones have been extensively used as second line agents in the management of type 2 diabetes. A small increased incidence of ischaemic heart disease was suggested by a meta-analysis of studies using Rosiglitazone. Similar meta-analysis of Pioglitazone did not show adverse cardiovascular outcomes. Our aim was to objectively evaluate the changes in glycaemic and lipid control in a controlled conversion from Rosiglitazone to Pioglitazone.<p cl...

Objective: To compare FreeStyle Libre Glucose management indicator (GMI) with HbA1c and fructosamine and assess factors related to the difference.Methods: Persons with type 1 diabetes on FreeStyle Libre from a single diabetes centre whose sensor was active >70% of the time were included. Baseline characteristics, latest HbA1c, fructosamine, full blood count, total protein and albumin were collected from medical records. Ambulatory glucose profile dat...

There is scant literature on various mental health parameters following treatment of hyperthyroidism. We present our initial results from an ongoing quality improvement project, jointly undertaken by the Endocrinology and Psychiatry teams.Aim: To evaluate anxiety, depression, ability to work and quality of life (QOL) of patients with hyperthyroidism on presentation and after institution of specific therapy.Method: We assessed 68 ne...

Introduction: Multiple endocrine neoplasia type 2 (MEN2) is an autosomal dominant multi-glandular tumour syndrome, caused by RET germline mutations.We present a family with three affected generations identified by predictive testing.Index case and cohort details: A 40-year-old lady referred to ENT clinic with a swelling in the neck. Ultrasound confirmed multinodular goitre with FNAC-THY3. Diagnostic hemithyroidectomy was followed by total thyroidectomy f...

A 40-year-old woman, who had developed oligomenorrhoea after discontinuing the contraceptive pill at age 30, presented with a 6-month history of intermittent vomiting associated with abdominal discomfort and distension. Ultrasound, followed by laparotomy, revealed multiple bilateral ovarian luteal cysts consistent with hyperoestrogenism and ovarian-hyperfunctioning.Only 9 months post-operatively her bilateral theca ovarian cysts had recurred. Over 4 mont...