Endocrine Abstracts

25-years-old lady presented to gastroenterologist with recurrent bouts of vomiting associated with abdominal pains, fatigue, muscle aches and dark tan. Initial biochemical profile and upper GI endoscopy were normal. On examination she had dark pigmentation of the palms well hydrated and haemodynamically stable. No family history of autoimmune conditions. She had traumatic laceration of the liver as a child, otherwise no significant past medical history.A...

Introduction: Empty sella syndrome is a condition in which sella turcica is partially or completely filled with CSF resulting in a displacement of normal pituitary gland. Primary empty sella is due to inherent weakness of diaphragm sella or to an increase in intracranial pressure which promotes herniation of arachnoid membranes in to pituitary fossa. More common in middle aged obese female and headache is the most common presenting symptom. It may be associated with one or mor...

Nesidioblastosis is a well recognized cause of persistent hyperinsulineamic hypoglycemia of infancy. Regardless of the pancreatectomy procedure used, hypoglycaemia may recur during long term follow up. We describe a challenging case of recurrent hypoglycaemic episodes in a young adult.We describe a 33-year-old landscape gardening laborer with history of insulin treated diabetes diagnosed at the age of 3 weeks old following subtotal pancreatectomy for nes...

A 43 year old hypertensive lady was referred to a surgical team at a tertiary oncology centre for consideration of completion thyroidectomy following removal of a nodule the histology of which had shown medullary thyroid carcinoma. She was reviewed in the cancer Multi-Disciplinary Team meeting; surgery was deferred until she had been reviewed in the endocrine clinic.There was no known family history of MTC or other endocrine abnormality; however the pati...

Case history: A 52 year-old lady was seen for further assessment of primary hyperparathyroidism (PHPT). She complained of intermittent symptoms of bloating but was otherwise asymptomatic. She was menopausal on hormone replacement therapy (HRT) and had started lithium for bipolar disorder 4 years ago. She had no known history of nephrolithiasis and no history of fractures. Her past medical history included Hodgkin’s lymphoma treated with chemotherapy 14 years ago, bipolar ...

Case history: 58 year old male presented in April 2016 with haematemesis. Octreotide-avid pancreatic mass with liver metastases was identified. Liver biopsy demonstrated well differentiated Grade 2 NET (Ki-67 10–13%). He progressed on Somatostatin analogue therapy, and subsequently Sunitinib, following which he underwent four cycles of Peptide Receptor Radionuclide Therapy (PRRT) with partial response. In May 2018, there was radiological progression. He reported episodes ...

Introduction: The 4th International Workshop on asymptomatic primary hyperparathyroidism (PHPT) has set criteria for surgical intervention and suggests that a percentage of patients can be managed conservatively. Imaging is indicated only pre-operatively to determine the optimal surgical approach.Patients and methods: We completed an audit on the use of Sestamibi, clinical and biochemical data in patients with PHPT.<...

Introduction: The 4th International Workshop on asymptomatic primary hyperparathyroidism (PHPT) has set criteria for surgical intervention and suggests that a percentage of patients can be managed conservatively. Imaging is indicated only pre-operatively to determine the optimal surgical approach.Patients and methods: We completed an audit on the use of Sestamibi, clinical and biochemical data in patients with PHPT.<...

Case history: A 56 year old man presented with a few months history of diffuse bone pain affecting his arms, legs, ribs and particularly his left hip. Past medical history included well controlled HIV infection, hepatitis B co-infection, peripheral neuropathy associated with HAART, lipoatrophy, Kaposi’s sarcoma, ADHD, type 2 diabetes mellitus, and a history of previous Fanconi’s syndrome associated with Tenofovir Disoproxil Fumarate (TDF) 8 years ago. At his initial ...

Introduction: The NHS Commissioning Board recommends the introduction of multidisciplinary Tier 3 Specialist Weight Management Services (SWMS) for adults with obesity. Unfortunately, these services are yet to be commissioned in many areas and this largely reflects financial barriers to their development. We have noted, through observation and feedback, that our Tier 3 service is highly valued by patients. Supportive evidence in the literature - although encouraging - is limite...