Endocrine Abstracts

Case history: Two cases:(1) NM 55-year-old man with no erectile dysfunction, normal libido, but low energy levels for 6 months. PH Hemithyroidectomy for benign nodule, CML with Philadelphia chromosome positive, vitamin D deficiency. Peripheral vascular disease secondary to kinase inhibitors.DH Sildenafil, aspirin, ibuprofen, MagnaPhate, Vitamin D3 1000 units, Levothyroxine 50 mcg, Imatinib 400 mg s...

Background: Hypokalaemia (potassium below 3.5 mmol/l) is a common electrolyte abnormality associated with cardiac instability and myopathies. Untreated hypokalaemia can lead to inpatient morbidity and mortality.1Aim: To review the management of hypokalaemia, in terms of potassium replacement therapy, potassium-level monitoring and cardiac monitoring, in Maidstone hospital.Methods: A cross-sectional study of inpatients wi...

Case history: The patient was a 17-year old lady who was referred to us by her primary care provider for hyperprolactinaemia and primary amenorrhoea. She was of short stature (0.4th centile for height and minus 2 centile spaces of the mid-parental height) and in the 9th–25th centile range for weight. There was no history of galactorrhoea. Her breast development was Tanner stage 3–4, and pubic hair 2–3, with no axillary hair. There was no evidence of any intellec...

An 82-year-old lady admitted after multiple episodes of collapse and her blood sugar levels were noted to be less than 2.0 mmol/l. A supervised controlled fasting test was performed and results were consistent with Insulinoma. Imaging revealed a mass in the tail of the pancreas with metastasis to the liver. Liver biopsy confirmed the diagnosis of a poorly differentiated neuroendocrine tumour. She continued to have hypoglycaemic episodes which were difficult to manage. Dietary ...

32 year old female with no prior past medical problems presented to hospital with a two week history of rapid onset delusional psychosis with religious themes, paranoid ideas and rapidly developing into catatonia. There was no previous history of psychiatric disorders. On physical examination the Glasgow Coma Score (GCS) was 15 and she was responding to visual hallucinations; speaking to imaginary person and reported seeing objects. She was afebrile and bedside observations we...

A 36 year old female patient presented to the emergency department with a generalised tonic-clonic seizure. She had a past medical history of epilepsy and tuberous sclerosis. Her medication prior to hospital admission was Tegretol which had controlled her seizures well for many years. On admission, the adjusted calcium level was 1.4 mmol/l with a raised ALP 508 U/l and a phosphate within the normal reference range at 1.1 mmol/l. Magnesium was also within the normal reference r...

This case illustrates a decision paradox on investigations (to exclude secondary hypercalcaemia) and treatment options (in unresponsive thyrotoxicosis despite supra-normal doses of carbimazole). A 56-year-old lady, who was referred with hyperthyroid symptoms and evidence of biochemical thyrotoxicosis, was also found to have symptomatic hypercalcaemia (constipation & polyuria). Investigations were as follows: FT4 >100 pmol/l, TSH <0.02 mU/l, TRAb positive, Ca 3.0 mmol/l...

Tyrosine kinase inhibitors (TKIs) are relatively new therapy drugs used for the treatment of metastatic cancers including Renal cell carcinoma (RCC), gastrointestinal stromal tumours, thyroid and neuroendocrine tumours. They block vascular endothelial growth factor and other growth factors Thyroid dysfunction is often a side effect of this treatment. A close monitoring of thyroid hormone levels is a necessity.We have a case of a 69-year-old lady with RCC...

Aim: Baseline clinical and biochemical endocrine assessment at the start of immune checkpoint treatment and each treatment cycle is important given the treatable nature of it. Also given the improvements in survival of these patients necessitate further longterm screening. Our study was to look at various aspects of this screening with a view to improve our knowledge and also patient care.Methods: Using an excel database, a retrospective data collection ...

Background: A 73-year-old female presented to the hospital with a 3-day history of right upper quadrant abdominal pain and episodes of vomiting. Her past medical history included insulin treated Type 2 diabetes diabetes, deep venous thrombosis for which she was on rivaroxaban, COPD, right leg angioplasty and previous p-ANCA vasculitis. She also had flank tenderness and was noted to be hypertensive with a blood pressure of 225/93mmHg. A CT scan of the abdomen identified a new 4...