Endocrine Abstracts

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...

Background: Iopanoic acid is an iodinated oral cholecystographic contrast agent, which can be used for the rapid blockade of thyroid hormone production in preparation for thyroidectomy, especially in patients who are intolerant of thionamides. However, appropriate timing of thyroid surgery is vital.Project: In this retrospective audit, we identified all patients with thyrotoxicosis who received pre-operative preparation with iopanoic acid from 2006 to 20...

Pheochromocytoma is a rare catecholamine-secreting tumor. It is potentially curable but can cause life-threatening hypertension or cardiac arrhythmias. We report a 58- years- old woman with no significant past medical history who was admitted through the emergency department with complaints of chest pain, palpitation, and nausea. She reported six months history of episodic palpitation and throbbing headaches, sometimes associated with light-headedness and dizziness. Hence, she...

Background: In any given week, 2.5% of diabetic patients have a foot ulcer. In the United Kingdom (UK), there are 7000 lower limb amputations in people with diabetes every year and the annual NHS expenditure on diabetic foot-related healthcare amounts to £1 billion. As per the National Institute for Health and Care Excellence guidelines in the UK, a person with diabetes needs to be referred to an MDT within 24 h of finding a foot ulcer. The National Diabetes Footcare Audi...

Introduction: Hypercalcaemia is well associated with metastatic malignancy. Hypocalcaemia is an uncommon complication of osteoblastic metastases and occurs most commonly with breast and prostate carcinoma.Case: A 46-year-old woman with metastatic breast carcinoma and osteoblastic skeletal metastases treated with denosumab presented with severe symptomatic hypocalcaemia. Serum calcium was persistently low with a nadir value of 1.45 mmol/l (2.2–2.6) a...

Objective: To determine whether people with an incidentally discovered adrenal mass are investigated according to regional and global standards (AACE guidelines); to determine the frequency of autonomous endocrine function.Methods: We did a retrospective analysis of clinical, pathology, and radiology records from January 2007 to December 2011. Patients were included if they were seen in the outpatient clinic for evaluation of an adrenal mass >1 cm in...

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...

Omnitrope is a biosimilar growth hormone (GH) preparation with a lower acquisition cost than other GH preparations. We switched adult patients with growth hormone deficiency treated with Genotropin (n=14, age 59.2±13.7 [mean±SD] yrs, 8 male) to Omnitrope at an equivalent dose. There followed titration visits every month for 3 months then visits every 3 months until 9 months. GH dose (0.5±0.0 vs 0.5±0.0 mg [mean±SD],...

A 66-year-old HIV positive male presented to gastroeneterologist with a 2 months history of severe fatigue, weight loss, dizziness and nausea. He had background of ulcerative colitis which was quiescent and he has not received steroids for more than 12 months. Baseline blood results revealed normal biochemistry with mild normocytic anaemia, neutropaenia and lymphopaenia. As there was a high clinical suspicion of adrenal insufficiency, the short synacthen test was performed whi...

Case report: A 76-year-old lady was referred to our Endocrinology department due to general malaise and abnormal thyroid function tests: TSH 1.1 (0.3–4.2) mU/l, fT4 30.6 (12.0–23.0) pmol/l, fT3 8.3 (4.0–7.8) pmol/l. She had received 131I twice, 16 and 36 years previously, at different hospitals for presumed thyrotoxicosis. She was clinically euthyroid and had a small diffuse goitre.Repeat thyroid function t...