Endocrine Abstracts

A 75 year old male presented in August 2017 with dizziness, nausea and weight loss. In ENT clinic he was found to have right vocal cord lesion. He had CT chest, abdomen and pelvis which showed mediastinal and hilar lymphadenopathy and bilateral adrenal lesions. A PET–CT scan showed intense metabolic uptake in the adrenals with low volume, but moderately active mediastinum and hilar lymphadenopathy. He was presumed to have adrenal and mediastinal Tuberculosis and was start...

A 26 year old man of Angolan descent presented to the endocrine clinic with poorly controlled hypertension (systolic blood pressure >200 mmHg). He had been treated with Amlodipine for almost six years, and more recently the addition of Irbesatan and Indapamide had not led to adequate blood pressure control. His hypertension was diagnosed at age 19 and progressive features of Cushing’s disease had remained unnoticed, with truncal striae, easy bruising, myopathy, puffin...

We present a case of a 29-year-old lady who presented with subfertility. She had had a 2 years history of oligomenorrhoea with highly irregular menses. She had symptoms of depression and described tunnel vision. Clinically, she was euendocrine with no features of hormonal excess or deficiency. She was not hirsute. Visual field testing demonstrated a severe left superior temporal quadrantopia.Laboratory investigations demonstrated an oestriadol level rang...

We present a case of severe thyroid-associated orbitopathy in a 44-year-old man with metastatic follicular carcinoma of the thyroid. He presented with a neck lump, and following further investigations, underwent a hemithyroidectomy followed by a completion thyroidectomy. Histology of the thyroid confirmed widely invasive follicular carcinoma of Hurthle cell type with foci of vascular invasion (pT3 Nx Mx). He received radioactive iodine ablation therapy (3.7GBq), ...

We present a case of severe thyroid-associated orbitopathy in a 44-year-old man with metastatic follicular carcinoma of the thyroid. He presented with a neck lump, and following further investigations, underwent a hemithyroidectomy followed by a completion thyroidectomy. Histology of the thyroid confirmed widely invasive follicular carcinoma of Hurthle cell type with foci of vascular invasion (pT3 Nx Mx). He received radioactive iodine ablation therapy (3.7GBq), ...

Introduction: Normocalcaemic hyperparathyroidism (nHPT) is a persistently elevated parathyroid hormone (PTH) with normal ionised calcium levels in the absence of secondary hyperparathyroidism. nHPT is proposed to be an earlier phase of hypercalcaemic primary hyperparathyroidism (PHPT). nHPT patients can present with progressive complications such as osteoporosis and nephrolithiasis. Currently, there is no diagnostic test to confirm primary hyperparathyroidism in nHPT patients,...

A 70-year-old lady, with a background of primary hypothyroidism presented to the Emergency department with a 1 day history of confusion and drowsiness. On examination her HR was 58 bpm, temperature 28 degrees celsius. She was resuscitated with warm fluids and bair hugger, whilst also given broad spectrum intravenous antibiotics. Her blood results showed an AKI with creatinine of 213 and was treated for a NSTEMI with a troponin on admission of 1770, rising to 2190. ECG showed p...

Insulin induced hypoglycaemia is a life threatening complication in T1DM. Sub-optimal counter regulatory response, with hypocortisolemia, threatens the recovery from insulin induced hypoglycaemia. We present a 28-year-old man with polyglandular autoimmune syndrome type 2 and life threatening hypoglycaemia, whose severe hypoglycaemic events were improved following introduction of CSII.The patient was diagnosed with Addison’s disease in 2000 and T1DM ...

Aim: In the thyrotoxicosis local investigation protocol, Tc99m pertechnetate scintigraphy technetium scan is used to assess the presence of thyroid uptake and both the degree and pattern of uptake. TSH receptor antibodies are used to demonstrate the presence and activity of autoimmune thyroid disease. We audited the utility of these investigations in a series of thyrotoxic patients.Methods: Forty-nine patients (11 men, 38 women, mean age 47.5±38) we...

We present a 44-year-old female referred to us with a two year history of episodic palpitations, chest tightness, headaches and pallor associated with hypertension. She had previously been extensively investigated by neurologists and cardiologists including MRI of the brain, renal ultrasonography, 24 h tape and echocardiography – all normal. Given the history, a CT of the adrenals was performed in 2007 which revealed a 1.5 cm nodule in the right adrenal with abnormal enha...