Endocrine Abstracts

We present the case of a 50 year old with primary hyperparathyroidism and 2 unsuccessful surgeries. Initially presenting in 2012 we question whether further surgical attempts to cure her should be made.She was found to have hypercalcaemia since 2009 with levels 2.60–2.80 mmol/l with PTH 21.9–28.9 pmol/l, vitamin D 9 nmol/l, ACE 37.8 iu/L, normal protein electrophoresis, creatinine 84 umol/l, phosphate 1.06 mmol/l, TSH 0.86 mU/l, Hb 142 g/l, and...

Introduction: Familial hypercholesterolaemia (FH) is a severe form of hyperlipidaemia resulting in early coronary heart disease (CHD). It has autosomal dominant inheritance with a prevalence of 1 in 500.Aim: Given this prevalence we would expect 1000 cases in our local catchment area of East and North Hertfordshire. Far fewer cases are know about. We tried to find out where potential cases were and assess the management of all cases.<p class="abstext...

We present the case of a 55 year old woman with Graves’ disease currently in remission but previous agranulocytosis with carbimazole therapy.She has a past medical history of Sjogrens syndrome on no medication. There is a family history of type 1 diabetes and thyroid disease in several members. She is Caucasian, a non smoker and drinks no alcohol. She is a primary school teacher.In December 2014 she presented to her GP with pa...

We present the case of a 51-year-old gentleman who had a giant parathyroid adenoma. He has a past medical history of deep vein thrombosis and hypertension. He is taking amlodipine 10 mg od. He is a non-smoker and drinks alcohol in moderation. He was admitted with right leg swelling found to be a new thrombosis. Incidental finding of extreme hypercalcaemia found on bloods with raised PTH (CorrCa 4.23 mmol/l, PTH 83.1 pmol/l.) Patient was completely asymptomatic. CT imaging of c...

A 37 year old woman was referred to the endocrinology clinic from the gynaecologists. She was awaiting an 8 cm left ovarian cyst removal and found to be hyperthyroid (fT3 7.8 pmol/l, fT4 of 19.0 pmol/l, TSH <0.01 mU/l). She described 4 months of palpitations, change in bowel habit and menstrual irregularity. She had no tremor or tachycardia. She had no palpable goitre or eye signs. She had a past medical history of asthma on inhalers. There was no family history of thyroid...

We present two patients who have increased uptake in the thyroid on PET imaging.Mrs AN is a 76-year-old woman with hypertension, atrial fibrillation, deep vein thrombosis and primary autoimmune hypothyroidism with positive TPO antibodies on thyroxine. When abroad she had a carotid USS which discovered a thyroid nodule. Referred to us she was euthyroid with an USS finding of a 5 mm calcified nodule with no vascularity in the right thyroid. She had a FNA i...

A 68 year old gentleman referred to endocrinology clinic with a few years history of erectile dysfunction (ED), which manifested as reduced libido and partial erections. Investigations revealed primary hypogonadism with a low morning serum Testosterone of 4.8 (Ref: 7.9-31 nmol/l), raised FSH at 47 (Ref:1.5-12.4 iu/l) LH at 36.8 (Ref: 1.7-8.6iu/l) and normal thyroid function tests (TFTs). The patient declined testosterone replacement therapy following a discussion of pros and c...

Introduction: Hypothyroidism can present in a variety of ways, from unexpected abnormal blood results in seemingly asymptomatic patients to those with a multitude of debilitating symptoms. Levothyroxine dose titration is a challenge often faced by physicians. We identified 8 difficult cases which following MDT discussion underwent the Thyroxine Absorption Test (TAT) to gain further clarification (Walker et al. 2013).Aim: To identify if the issue...

This is a case of a 48-year-old lady initially referred to respiratory clinic with symptoms of breathlessness. She had a high-resolution CT thorax where an incidental finding of a right para-oesophageal 2.4-cm soft tissue density at the level of the thyroid gland identified. A CT neck was performed for further evaluation again showed the soft tissue mass (26 mm×37 mm) situated to the right of the oesophagus and another mass (16 mm×26 mm) left of the oesophagus. Discu...

Current UK guidelines for thyroid nodules advise a thyroid ultrasound (ThyUSS) with U-Classification with or without Fine Needle Aspiration (FNA) with Thy-Classification to determine malignancy risk. We report four cases where thyroid carcinoma was diagnosed histologically following reassuring cytology and radiological examination. This is a case of 28-year-old female who presented with neck swelling. ThyUSS showed an enlarged left thyroid with cystic and solid components; FNA...