Endocrine Abstracts

A 71 year old gentleman presented with polydipsia, polyuria and nocturia for two weeks and weight loss of 10.5 Kg over the preceding two years. He had hypertension controlled with valsartan, hydrochlorthiazide, amlodipine and doxazosin. His average alcohol intake was 55 units per week. His brother had diabetes of uncertain aetiology. Examination was unremarkable apart from mild dehydration. His body mass index was 28 kg/m2 and there...

A 71 year old gentleman presented with polydipsia, polyuria and nocturia for two weeks and weight loss of 10.5 Kg over the preceding two years. He had hypertension controlled with valsartan, hydrochlorthiazide, amlodipine and doxazosin. His average alcohol intake was 55 units per week. His brother had diabetes of uncertain aetiology. Examination was unremarkable apart from mild dehydration. His body mass index was 28 kg/m2 and there...

A 34-year old pregnant lady had induction of labour with prostaglandins and oxytocin infusion after her due date. She failed to progress in labour and became slightly disoriented. Urgent biochemistry revealed serum sodium of 124 mmol/l. She delivered a healthy baby by forceps but had post-partum haemorrhage of 1.5 l. Oxytocin infusion was continued along with Hartmann’s solution. She became drowsy and biochemistry revealed serum sodium of 118 mmol/l, low serum osmolality,...

Background: Primary hyperparathyroidism is one of the most common disorders encountered in endocrine clinics and primarily affects women. The current recommendation for patients with primary hyperparathyroidism is to undergo parathyroidectomy which has a 97% success rate. However, there is a small group of patients where surgery is contraindicated, or patients who have a disease pattern not amenable to surgery or patients who refuse surgery. These patients would require an alt...

Patients with type 1 diabetes (T1DM) and insulin hypersensitivity reaction of any type are at high risk of acute and chronic long term complications of hyperglycaemia and glycaemic variability. Such patients are challenging to manage. We present a case report. A 57 year old lady with T1DM for 21 years managed with insulin pump for 7 years reported new onset intermittent skin reaction at the pump infusion site over the last two years. She described her skin becoming swollen and...

A 37-year-old female, referred by gynaecologist with low prolactin and free T4 after work up for secondary amenorrhea despite removal of contraceptive coil 18 months ago. Her only daughter was born seven years ago with no complications. Patient admitted to have tiredness and dizziness for a few years but denied headache or visual symptoms. Pituitary hormone profile confirmed secondary hypothyroidism, secondary hypogonadism, low prolactin, low IGF-1 level but normal adrenal axi...

Background and objectives: Ineffective communication is one of the leading causes of medical errors and patient dissatisfaction. We implemented an initiative for dynamic endocrine tests to enhance communication with primary care colleagues and patients.Methods: We introduced a comprehensive system of organising dynamic tests, structured documentation, weekly endocrine meeting to discuss the results and standardised escalation process for suspected abnorm...

Hypercalcaemia is one of the common cases seen in Endocrine clinics. We report another challenging case of hypercalcaemia. A 43 old Asian man was referred by GP initially in 2011 with asymptomatic hypercalcaemia of 2.87 mmol/L. His past medical history included chronic plaque psoriasis with arthropathy, hypertension, stage 3 CKD, Fatty liver with mild fibrotic change secondary to methotrexate and learning difficulties. Hypercalcamia was thought to be contributed by Dovonex (Ca...

61-year-old-male with a background of treated hypertension and dyslipidaemia presented to accident and emergency with progressive shortness of breath. His most recent bloods were within normal limits. He has a positive family history of cardiac disease, and underwent investigation by CT scanning. This revealed a 10.2 mm anterior mediastinal nodule, which was not avid on PET CT scan. His case was reviewed by the respiratory team and he underwent a left VATs thymectomy. Thymic t...

59-year-old male, with a background of treated acromegaly, presented to endocrine clinic with new onset fatigue. He was diagnosed with acromegally 18 years prior to his presentation, and had a transphenoidal hypophysectomy followed by gamma-knife radiation. Post-surgery he developed partial anterior hypopituatrism (LH and FSH). He currently takes testosterone replacement. He is still receiving medical management with Somatuline. He developed hypothyroidism 16 years following h...