Endocrine Abstracts

We report an 84-year-old lady with stage A chronic lymphatic leukaemia which has been stable since 2002. She presented to our A&E in January 2013 with 3 days history of worsening frontal headache. She did not report visual disturbance or weakness. Examination revealed right sided homonymous hemianopia with no other neurological deficit.White cell count and lymphocytes were 53.9×109/l and 42.0×109/l respectively. CT hea...

Case history: A 34-year-old man attended the emergency department with a history of sudden onset severe headache associated with vomiting, neck stiffness mild photophobia not relieved with analgesia. He reported a past medical history of hypertension treated with angiotensin-converting enzyme inhibitor (ACEi). There was no focal neurology, and his observations were unremarkable - blood pressure 121/64 mmHg, heart rate 54 beats per minute, respiratory rate 14 breaths per minute...

During starvation, ketone bodies acetoacetate and 3-D-hydroxybutyrate are freely soluble energy substrates made by the liver. Their major role is to supply an alternative glucose substrate for the brain under conditions of medium- and long-term energy restriction. The most common cause of pathological ketoacidosis is poorly controlled type 1 diabetic mellitus triggering uncontrolled hyperglycaemia. Other common causes are alcoholic ketoacidosis and fasting ketosis. In non-diab...

We describe the case of a 22-year-old South Asian male presenting to Endocrine Services with morbid obesity (BMI>50), sexual immaturity and agoraphobia. Born at full term following an uncomplicated pregnancy, he reached all developmental milestones appropriately. His problems began aged 15 after witnessing a murder, with reactive depression and hyperphagia. By the age of 18, he weighed over 140 kg, had poor self-image and suicidal ideation. He was managed initially by seve...

The combination of hypophosphataemia and hypercalcaemia has numerous aetiologies, which can be challenging in the clinical setting. Careful early biochemical identification will facilitate appropriate further imaging and management. We report a case of a gentleman who presented in his ninth decade with deteriorating cognition, proximal muscle weakness and reduced mobility on a background of hypertension, type 2 diabetes with associated ...

The combination of hypophosphataemia and hypercalcaemia has numerous aetiologies, which can be challenging in the clinical setting. Careful early biochemical identification will facilitate appropriate further imaging and management. We report a case of a gentleman who presented in his ninth decade with deteriorating cognition, proximal muscle weakness and reduced mobility on a background of hypertension, type 2 diabetes with associated ...

We describe the case of an Asian male who is currently 20 years of age. He originally presented aged 18 months with short stature (height below 3rd centile). Isolated growth hormone (GH) deficiency was confirmed by an insulin tolerance test (normal thyroid function/cortisol/GH antibodies). He commenced GH injections (1 unit/day), to which he responded well, reaching the 50th centile for height within one year. Due to his parents’ wishes, GH therapy was discontinued at 3 y...

Amiodarone-induced thyroiditis (AIT) can be a diagnostic and therapeutic challenge. It can be a diagnostic challenge in clinical cases, where response to therapy can be slow. It is important to achieve an early differentiation between various subtypes (i.e. AIT type 1 or AIT type 2) to guide therapy. We present a case of a 51-year-old man with a history of paroxysmal atrial fibrillation for which he was treated with a maintenance dose of Amiodarone. He presented ...

Amiodarone-induced thyroiditis (AIT) can be a diagnostic and therapeutic challenge. It can be a diagnostic challenge in clinical cases, where response to therapy can be slow. It is important to achieve an early differentiation between various subtypes (i.e. AIT type 1 or AIT type 2) to guide therapy. We present a case of a 51-year-old man with a history of paroxysmal atrial fibrillation for which he was treated with a maintenance dose of Amiodarone. He presented ...