Endocrine Abstracts

We present a case of a 50 year old patient with sepsis and a significant and symptomatic hypercalcaemia of 3.38 mmol/l with a background of MS. The infection responded to treatment however the hypercalcaemia persisted despite appropriate measures. Further investigation showed a suppressed PTH, normal ACE level, electrophoresis and 25(OH) vitamin D level, but found her to be thyrotoxic with TSH suppressed at <0.01, free T4 – 37.2 nmol/l, free T3 – 212 nmol/l. She ...

Introduction: X-linked adrenoleucodystrophy (XALD) is a progressive disorder affecting adrenal glands, testis, and myelin stability, that normally caused by mutations in ABCD1 (NM_000033) gene There is a failure of β-oxidation of fatty acids within peroxisomes due to reduced activity of very long chain acyl-CoA synthetase and can be diagnosed by the demonstration of elevated very long chain fatty acid.Case report: We report a case of a 32-y...

Objective: Most hypothyroid patients require an optimal dose of 1.6–1.8 μg/body weight (kg) of L-thyroxine to restore a normal TSH. Poor response to treatment can be due to malabsorption, drugs interaction and poor compliance. We conducted a test to determine the likely cause of persistent hypothyroidism in a coeliac patient despite taking supraphysiological doses of L-thyroxine (>1000 μg OD).Case...

A 73 years old gentleman with a diagnosis of mesothelioma presented with symptoms typical of hypoglycaemia. Other than the expected abnormal chest signs there were no significant examination findings.Capillary glucose was unrecordable; lab testing confirmed serum glucose of 0.9 mmol/l. He had no history of diabetes mellitus or any medication that may induce hypoglycaemia. There was a slight rise in CRP and white cell count was elevated. There was no clin...

Background: The short Synacthen test (SST) is frequently used to diagnose adrenal insufficiency; however the role of baseline cortisol. With the recent European shortage of synacthen, there was a pressing need to identify the best possible way to use the resource and rationalize the test. Our aim is to identify whether baseline cortisol can be safely used to rule out adrenal insufficiency in clinical practice.Methods: All SSTs performed at the OPD, Royal...

Section 1: Case history: A 78 years old lady presented to Emergency Department with two weeks history of lethargy and confusion. She had background of advanced destructive Rheumatoid Arthritis diagnosed 30 years ago, multiple joint fractures, osteoporosis, long-term urinary catheter, recurrent UTI and renal calculi. She was recently discharged from hospital for urosepsis. She was bed-bound for the last 15 years after crushing vertebrae C2 C3 pressing on spinal cord. Her regula...

Introduction: Recent randomised controlled trials have demonstrated the efficacy of very low calorie diets (VLCD) in carefully selected patients with type 2 diabetes mellitus (T2DM). However, there is paucity of evidence regarding the efficacy of VLCD in the real-world setting. We evaluated outcomes in obese T2DM patients who underwent VLCD at our institution.Methods: This retrospective observational study included all patients who had undergone VLCD fro...