Endocrine Abstracts

Hyperthyroidism complicates ~1 in 1000–2000 pregnancies, with majority of cases due to Grave’s disease (GD). PTU remains the preferred ATD of choice in pregnancy with carbimazole a reasonable second-line alternative in patients allergic or intolerant to PTU. We present the case of a lady with PTU induced agranulocytosis in pregnancy.A 29-year-old lady was seen in thyroid clinic in May 2006 having had symptoms suggestive of thyrotoxicosis since ...

: A 67-year-old lady, previously fit and well, presented with chest pain. She denied gastrointestinal or urological symptoms. There was no history of depression, psychosis, previous hip fracture or steroid use. She had regular menstrual cycles until hysterectomy at 50 years of age. She doesn’t smoke or drink alcohol. Her mother and father had oesophageal and lung cancer respectively with no family history of hypercalcemia. On examination, she was normotensive with BMI 23....

: A 67-year-old lady, previously fit and well, presented with chest pain. She denied gastrointestinal or urological symptoms. There was no history of depression, psychosis, previous hip fracture or steroid use. She had regular menstrual cycles until hysterectomy at 50 years of age. She doesn’t smoke or drink alcohol. Her mother and father had oesophageal and lung cancer respectively with no family history of hypercalcemia. On examination, she was normotensive with BMI 23....

Introduction: Adrenal Incidentalomas (AI) are frequently encountered in clinical practice with radiological studies suggesting a frequency of 3% at 50 years rising to 10% in elderly. Majority of AI are non functional adenomas with malignant lesions quoted as less than 20% at most. We report a case of AI, which was found to a Melanoma on biopsy with no other primary site.Case: An 84 year old gentleman was found to have a right suprarenal mass on ultrasoun...

Introduction: Metastatic lesion in the pituitary is a rare condition with most of them being asymptomatic. Breast cancer is the most frequent primary location and the overall prognosis is poor. We describe the case of a lady with this condition, who presented to our unit with bitemporal hemianopia.Case: A 65 year old lady with history of breast cancer (surgical excision with chemoradiotherapy 4 years ago, HER2 negative, currently in remission) presented ...

Introduction: Orthostatic hypertension (OHT) is a phenomenon which may represent increased cardiovascular risk and is less well recognized compared to orthostatic hypotension.Case: A 65 year old gentleman presented with symptoms of lethargy and episodic shaking. He has a history of treated prostate cancer and was not on any regular medications. He noticed consistently elevated blood pressure on standing during home monitoring. His lying BP was 142/82 and...

A 26-year-old female presented with 5-year history of episodic muscle weakness, abdominal cramps and facial paresthesia. She had 2 hospital admissions elsewhere within 6months with severe hypokalaemia (1.9 mmol/L). She was started on Lamotrigine for epilepsy 7 years ago and changed to Levetiracetam in October 2010 following further seizures. She is now seizure-free for over 5 years. Her potassium levels before and after Levetiracetam are shown in Table 1.<table boarder="1"...

A 59-year-old lady was admitted with lethargy and dehydration in October 1998 and investigations confirmed primary hyperparathyroidism with corrected calcium 4.49 mmol/l (N: 2.1–2.6). After fluid resuscitation, she underwent parathyroidectomy and biopsy revealed parathyroid hyperplasia. Post-operatively, her calcium remained normal until November 2000 when her corrected calcium was 3.05 mmol/l with PTH 311 ng/l (N: 12–65). Sestamibi scan failed to local...

A 69-year-old man with no family history of thyroid disease presented with weight gain and constipation. He was clinically euthyroid with no goitre. Investigations confirmed autoimmune hypothyroidism with FT4 16.9 pmol/l (N: 10–22), TSH 29.14 mIU/l (N: 0.4–4.5), elevated thyroid peroxidase (TPO) antibodies 3311 IU/ml (N: 0–34) and he was commenced on thyroxine with serial dose adjustments to 250 mcg OD over 2 years. His TSH however remained ...

Introduction: Resistance to thyroid hormone (RTH) is an autosomal dominant condition with mutation of thyroid hormone receptor beta (THR-β) gene. We present 2 cases with unusual thyroid picture posing challenge to diagnosis.Case 1: 31-year-old lady presented with 6-month history of anxiety, tremors, insomnia and headache. She suffered from asthma and had a family history of hyperthyroidism. On examination, she was o...