Endocrine Abstracts

A 69-year-old lady presented to the ophthalmologists in view of a right 6th cranial nerve palsy and headache. Neuroimaging showed a central and right sided base of skull tumour with involvement of multiple cranial nerves (3rd, 4th, 6th). An endoscopic biopsy was inconclusive. She presented to the medical team few days later with drowsiness, lethargy, and her sodium was found to be 117 mmol/l with a potassium of 5.5 mmol/l. Serum osmolality was 267 mOsm/kg, urine osmolality was...

A 42-year-old lady, with a diagnosis of Graves’ disease presented with a day’s history of fever, cough, coryzal symptoms and diarrhoea. Being diagnosed with Graves’ disease in 2015, she had been poorly compliant with ATDs. Prior to this presentation, her last FT4 was 31.4 pmo/l with a suppressed TSH. She was intermittently taking propylthiouracil (was intolerant of carbimazole). She had refused RAI and preferred surgery, but hadn’t been keeping up with her ...

Metastasis to the pituitary gland is a rare occurrence. Here we discuss our experience managing a patient with pituitary neuroendocrine metastasis who first presented with ocular symptoms. A 65-year-old lady presented in July 2015 with progressive diplopia. An MRI scan revealed a pituitary mass lesion with aggressive features and two abnormal enhancing nodules within the brain white matter, raising suspicion of metastatic disease. Radiotherapy was commenced on the basis that t...

Case: A 66-year-old female was referred to the Endocrinology clinic for suspected osteoporosis after a right femoral shaft fracture. As the site was atypical and the injury was low energy, a pathological fracture was suspected. There was a history of recurrent fractures sustained after the age of 30 years and were either spontaneous or from low-energy impacts (Table 1). Growing up, she was told that “there was something wrong with her bones” and required regular phys...

Case: A 59-year-old female with a past medical history of surgically treated primary hyperparathyroidism (PHPT) and breast cancer presented with irregular periods, post-menstrual bleeding, hot flushes, fatigue, and left loin pain. Furthermore, she reported weight gain of approximately 8 lb over 6 months and easy bruising in the absence of antiplatelet and anticoagulant therapy. There were no central, respiratory, or gastrointestinal symptoms. She was normotensive, and the clin...

A 25 year old gentleman was referred to the endocrine clinic for evaluation of abnormal thyroid function tests. He reported symptoms of diffuse abdominal pain associated with loose stool up to six times a day with urgency, frequency and tenesmus. These symptoms had been present since childhood, becoming increasingly troublesome over the preceding two years. He also reported symptoms of tiredness, palpitations and sweating episodes. Thyroid function tests were abnormal. TSH was...

Introduction: Hypothyroidism is characterized by a decrease in oxygen and substrate utilization by major organ systems of the body. Hence patients with angina have fewer symptoms if they become hypothyroid. Hypothyroidism also results in bradycardia and weakening of myocardial contraction. Cardiac preload is decreased, afterload is increased, and chronotropic and inotropic functions are reduced. The impairment of these measures leads to a reduction in cardiac output.<p cla...

This case study presentation formed the summative assessment aspect of “The principles of care for the child and young person in Endocrinology” module at London Southbank University. Hyperinsulinaemic Hypoglycaemia (HH), is characterised by the inappropriate secretion of insulin from the pancreatic β-cells in relation to the blood glucose concentration, and is the most common cause of severe and persistent hypoglycaemia in infancy and childhood. Approximately on...

Aim: To evaluate the management of patients with hyperthyroidism against recommendations of the American Thyroid Association (ATA).Methods: The case records of all new patients referred with hyperthyroidism, 02.05.2009–01.04.2011, were analysed (n=33), against recommendations of ATA.Results: 73% of the subjects were women. 24% patients had Graves’ disease, 18% MNG, 18% thyroiditis, 15% ‘autoimmune hyperthyr...

Case History: A 64-year-old gentleman presented with progressive exertional breathlessness since 1 year. He had started noticing pigmentation in the eyes 2 years back, and gave a history of passing black coloured urine since childhood. He had never consulted a medical professional for the same. Examination revealed hyperpigmentation of both ears and conjunctivae, and an ejection systolic murmur (Grade V) at the aortic area, which radiated to both his carotids. A sample of his ...