Endocrine Abstracts

A 56 year old man with history of Hypertension, “Pre-diabetes” and Osteoarthritis was noted to have a low morning Cortisol of 31 nmol/l at 0912 hrs and <28 nmol/l at 0741 hrs on the first and 4th postoperative days respectively following a left total knee replacement. His regular medications were Amlodipine 5mg OD, Ramipril 5mg OD, Bisoprolol 3.75mg OD, Atorvastatin 20mg HS, Gabapentin 100mg TDS. Post operatively he was also given Zomorph 10mg BD with Oramorph PR...

A female born in 1950, with history of Coeliac Disease since 1985, hypolactasia, pernicious anaemia, osteoporosis, asthma, lymphocytic colitis and non-alcoholic fatty liver disease with portal hypertension was referred to the Endocrinology team in June 2021 as the calcium was noted to be high. She had strongly positive anti endomyseal antibody, high Tissue Transglutaminase tire and duodenal biopsy proved villous atrophy with no evidence of Enteropathy associated T cell Lymphom...

Introduction: Graves’ disease is a common condition which is usually treated with antithyroid drugs like carbimazole and propylthiouracil. Here we present a patient who developed severe hypoglycaemia after treatment with carbimazole for hyperthyroidism which is unusual in Indian population.Case report: A 31-year-old male Indian presented to Endocrine Clinic with typical signs and symptoms of thyrotoxicosis. His biochemistry showed FT3: 28...

Objective: Amiodarone is an iodine rich, potent antiarrhythmic drug that is highly lipid soluble and total body iodine stores remain increased for up to 9 months. Abnormal thyroid functions, either thyrotoxicosis or hypothyroidism occur in upto 14–18% of patients receiving long-term amiodarone therapy. Hence regular thyroid function tests are required in patients on long-term amiodarone treatment. The BNF clearly states that thyroid function tests should be done at a mini...

Background: NICE has issued the guidelines regarding the use of alendronate in the secondary prevention of osteoportic fragility fracture in women above 75 years in whom DXA scan is clinically inappropriate or not feasible and considered to have osteoporosis by the responsible clinician.Objectives: We conducted an audit on inpatients at the James Paget University Hospital to examine whether patients are receiving the appropriate interventions as stated i...

A 46-year-woman was admitted with decreased appetite, weight loss, nausea, constipation, poor concentration, cough and shortness of breath on exertion. She had long standing history of low backache and had been taking paracetamol and codeine in combination, amitriptyline, tramadol, stemetil, diclofenac, and calcichew D3 one tablet/day On examination, blood pressure was elevated, erythematous nodules seen over right shin. Initial investigations showed normocytic anemia, elevate...

A 50 years old man was seen in the Endocrine clinic with elevated calcium (2.80 mmol/l, normal 2.20-2.60) and Parathyroid hormone (10.7 pmol/l, normal 1.6-6.9) levels. His medical background includes Alport Syndrome, Renal Allografts (1st 1990, 2nd 2000 and 3rd 03/11/2005), and Osteopenia on DEXA scan in February 2020. He did not have any renal stones in the past. There was no family history of hypercalcemia. He was on Vitamin D 1000 Units daily (Vitamin D 55 nmol/l, normal 50...

A male, born in 1957, with history of familial spinocerebellar ataxia, Type 2 diabetes (diagnosed in 1999), asthma, learning difficulties, chronic pancreatitis, recurrent falls, multiple low trauma fractures and osteoporosis was referred to Endocrinology Department in 2019. He sustained a right radial fracture at the age of 34 (1992), followed by comminuted right distal radius and Ulna styloid process fracture in 2002, Left and right Neck of Femur fractures in 2013 and 2014 re...