Endocrine Abstracts

Introduction: Causes of hypophosphataemia include reduced intestinal absorption, inadequate intake, transcellular shifts (refeeding syndrome, glucose/insulin infusion), renal loss which is either FGF23 mediated (inherited forms or tumour induced osteomalacia) or non-FGF23 mediated (hyperparathyroidism, drugs)Case report: We present a case of 51 years old female referred to us with multiple fractures during her half marathon. She suffered from bilateral m...

Diabetic lipemia, remains a well recognized but rare manifestation of uncontrolled diabetes mellitus. Although prompt diagnosis and insulin treatment have probably reduced the incidence of hyperlipemia in symptomatic diabetes, reports of this poorly understood syndrome continue to appear. 48 year old male presented with a 2 day history of severe epigastric pain, radiating to his back. Associated symptoms included nausea with vomiting. Lethargic, tired and associated headaches....

Introduction: Alemtuzumab is humanized monoclonal antibody used in the treatment of relapsing–remitting multiple sclerosis (MS). The 5year incidence of thyroid adverse events in phase-3 clinical trials is up-to 40.7%. In most cases, the thyroid dysfunction is mild and easily manageable. Hyperthyroidism, particularly Graves’ disease (GD) is more common. We describe a case of unusual thyroid dysfunction in a patient treated with Alemtuzumab.Case:...

Introduction: Congenital Adrenal Hyperplasia (CAH) is a rare genetic disorder characterised by deficiency of cortisol and/or mineralocorticoid hormones with over production of sex steroids. 21-hydroxylase deficiency is the commonest cause of CAH accounting for 95% of cases. Severe form of classic CAH occurs in 1 in 15 000 live births.Case report: A 30 year old women with CAH diagnosed at birth was on replacement with hydrocortisone and fludrocortisone. S...

Introduction: Primary testicular lymphoma is very rare and constitutes about 2% of all extra nodal lymphomas, mostly in men above the age of 60. Bilateral adrenal masses could be due to metastatic disease, congenital adrenal hyperplasia, bilateral macro-nodular hyperplasia, adrenal adenomas, lymphomas, infiltrative diseases, amyloidosis and infections like tuberculosis. Metastasis occurs most commonly from lung, bowel, breast and pancreatic cancer. Metastasis from lymphomas is...

Thyrotoxicosis is one of the most common clinical problems in patients referred to endocrine clinic. TRAb is specific for graves disease (GD) and radioisotope scan (RIS) is useful diagnostic test in the investigation of thyrotoxicosis. RIS is commonly used when TRAb is borderline or negative to exclude thyroiditis.Aims and methods: To look at the use of RIS in the investigation of thyrotoxicosis and sub-clinical hyperthyroidism (SCH), and use of anti-thy...

Introduction: Sclerochoroidal calcification is an uncommon condition that classically manifests as multiple discrete yellow placoid lesions, often discovered as an incidental finding. It is ordinarily believed to be idiopathic, but is also associated with primary hyperparathyroidism. It is important that these patients are identified because of the systemic implications and treatable nature of these disorders.Case: 82 years old patient with history of Pr...

Introduction: Thyroid Ultrasound (US) is the recommended first line investigation of suspected thyroid nodules. Specific radiological features, such as micro-calcification, low echogenicity, solid consistency, heterogeneity and ill-defined margins, raise the possibility of underlying malignancy. These findings together with fine needle aspiration cytology guide the management of thyroid nodules. The aim of this audit was to evaluate the quality and adequacy of thyroid US repor...

Papillary microcarcinoma (PMC) of thyroid is being increasingly detected following thyroid surgery for various reasons. The management of incidental PMC, not clinically or radiologically evident, is not well defined often leading to over treatment. Identifying risk factors for recurrence could help in administering appropriate management.Aims and methods: To review the incidence of PMC and management locally. Retrospective review of case notes of patient...

Introduction: Cardiomyopathy as the initial presentation of phaeochromocytoma (PCA) is uncommon. Diagnostic workup and perioperative management may be challenging within this context. We report three cases of PCA presenting with cardiomyopathy to illustrate the pitfalls in diagnosis and management. None of the patients had typical adrenergic symptoms of catecholamine excess and all patients were well established on beta-blockers on presentation. All three patients had an adren...