Endocrine Abstracts

Adrenal Leiomyomas are very rare tumours. 20 cases have been reported to date. Their management remains difficult and challenging. They tend to present with flank or abdominal pain and have very little biochemical activity, if any.Case presentation: We present a case of a young 44 year old female. She was referred to Endocrinology services with a history of 2 weeks abdominal pain. She underwent an ultrasound organised in primary care which was suspicious...

The standard management for Grave’s thyrotoxicosis includes the use anti-thyroid drugs, surgery and radioactive iodine treatment. In certain situations,alternative methods including bile acid sequestrants and therapeutic plasma exchange (TPE) have proven effective especially when other treatment modalities fail. We describe a case where conventional and alternative non-invasive measures failed to restore an euthyroid state and resorted to emergency thyroidectomy. A 49 yea...

Introduction: Pheochromocytoma is extremely rare in pregnancy and occurs 1 in 54000 pregnancies. If undiagnosed, Maternal and fetal mortality amounts to 40–50%. Early detection and prompt treatment decreases the maternal and fetal mortality to <5% and <15% respectively. There are multiple and complex issues in managing this condition in pregnancy. We would like to present such a case with very good outcome.Case: 28-year-old woman was admitte...

Introduction: A significant number of patients are intolerant of anti-thyroid drugs (ATD) and thyroidectomy remains the only treatment option available to patients who decline radioiodine as definitive therapy. As patients with poorly controlled thyrotoxicosis are at risk of developing thyroid storm, optimal pre-operative control of hyperthyroidism is essential. Rapid thyroid blockade (RTB) with the contrast agents sodium ipodate and iopanoic acid were attractive treatment opt...

Case report: A 65-year-old fisherman presented with altered mental status, agitation, generalised oedema, dyspnoea, liver impairment and severe persistent hypokalaemia (2.2 mmol/l). History: COPD, IPF (on steroids since May 2012), ex-smoker. Physical examination: deeply tanned, Cushingoid facies, severe proximal myopathy. Medications prior to admission: prednisolone 40 mg OD, furosemide 40 mg OD, inhalers, and lansoprazole. In a view of clinical and biochemical features of ste...

Background: Autoimmune Graves’ disease is the most common cause of hyperthyroidism. Medical management of Graves’ thyrotoxicosis with thionamides is complicated by a reported relapse rate of about 60%.Aims: The aims of this study were to determine the relapse rate of patients treated with drugs as first line treatment for Graves’ disease and to assess the impact of patient demographics, serum free T4(fT4) and clinical characteristics on re...

Objective: Hypothyroidism is common and predominantly managed in primary care. Symptoms are non-specific, with thyroid function tests (TFT) required for diagnosis. We sought to investigate current practice in levothyroxine prescribing in primary care.Methods: We studied the initiation of levothyroxine using the General Practice Research Database (GPRD), the world’s largest database of anonymised medical records. Individuals with i) thyroid cancer ii...

Introduction: British Thyroid Association Guidelines state that the diagnosis of thyroid malignancy cannot be based on the results of an aspiration’s cytology alone and will usually require surgical removal for confirmation. There has been much debate about the management of indeterminate fine needle aspirations (Thy 3). Recent publications have reported that the prevalence of thyroid carcinoma following a Thy 3 result to be as high has 28%, emphasising the importance of ...