Endocrine Abstracts

Case history: PD is a 57-year-old female teacher who presented to her GP in October 2017 with lethargy, dyspnoea and anaemia. Bone marrow biopsy followed by a CT scan of her chest and abdomen confirmed lobular breast cancer with peritoneal and bone metastases (ER+/HER2−). The patient also had an MRI scan of her head to assess for intracranial metastatic disease which was negative at the start of December 2017. She was commenced on letrozole, palbociclib and denosumab. A ...

Hyponatremia generally defined as a serum sodium of less than 135 mmol/l is the most common type of electrolyte imbalance found in older adults. Its mild to moderate forms can predispose patients to falls, fatigue and a general decline. Severe hyponatremia can contribute to seizures, confusion and death. We present a case of a 70-year-old lady with severe symptomatic chronic hyponatremia secondary to SIADH. She also had progressive Alzheimer’s dementia, anxiety, T1DM, hyp...

Case history: A 61 year old male with a background of diabetes mellitus Type 2 and congestive cardiac failure (CCF) was diagnosed with Cushing’s disease in 2014 following identification of severe osteoporosis through investigations for non-traumatic vertebral fractures causing paraplegia.Investigations: He had high ACTH and cortisol levels which failed to suppress on low and high dose dexamethasone suppression tests, hypogonadotrophic hypogonadism a...

Section 1: A 77 year female was referred by her GP in May 2019 for abnormal thyroid function tests (TFT) which were requested due to new diagnosis of atrial fibrillation. The patient was otherwise asymptomatic and clinically euthyroid. Family History was negative for thyroid abnormalities. On enquiry, the patient revealed that she had abnormal thyroid function tests associated with a large goitre in 1970s and subsequently underwent partial thyroidectomy followed by radioactive...

Background: The aetiology of hyponatraemia in SARS-CoV-2 (COVID-19) is complex. Early studies have suggested a syndrome of inappropriate anti-diuretic hormone picture. We undertook a real-world retrospective analysis of patients with hyponatraemia and COVID-19 hospitalised over a 12-month period and evaluated practice against European hyponatraemia guidelines to see if initial investigations and management were appropriate. Additionally, we evaluated whether hyponatraemia in C...

Background: For patients in an adrenal crisis, the timely administration of parenteral hydrocortisone can be life-saving. Data from the Addison’s Disease Self-Help Group found that a large proportion of adrenal crises occur out of hospital, with many patients relying on the emergency services for initial parenteral hydrocortisone administration. Despite regular patient education (including parenteral hydrocortisone self-administration) and recommendations to wear steroid...

Case history: A 25 year old primigravid woman was referred through to the Joint Antenatal clinic with a 15-year history of Diabetes Mellitus Type 2 treated with metformin. Her past medical history included polycystic ovarian syndrome, (causing significant hirsutism and amenorrhoea), non-alcoholic fatty liver disease, dyslipidaemia and hypertension (previously investigated for secondary causes). Her HbA1c was well controlled at 30 mmol/mol, and her Metformin had been discontinu...

Case history: A 26-year-old female with a past medical history of migraines was admitted to the Emergency Department (ED) with severe hypoglycaemia after drowsiness was noted by her partner in the early hours of the morning. On initial paramedic assessment, the patient had a reduced Glasgow Coma Scale (13/15), hypoglycaemia (capillary blood glucose of 0.9 mmol/l [16.2 mg/dl]), hypothermia (34.3 degrees Celsius [°C]) and bradycardia (heart rate 41 beats per minute). The patient...