Endocrine Abstracts

A 40-year-old female presented with lethargy, poor mobility and blurred vision for 2 weeks and 6 months of amenorrhoea. On examination she was markedly Cushingoid with proximal myopathy and normal visual fields. She was hypertensive, with peripheral oedema and leg ulcers. Bloods revealed leucocytosis, hyperglycemia, and ketonuria. She was commenced on insulin. CXR was clear.Endocrine review diagnosed Cushings syndrome. Cortisol did not suppress overnight...

Introduction: Lifelong corticosteroid replacement is the treatment for patients with Addison’s disease. Steroid therapy need to be altered in the event of illness such as infection, accident or any other major stress. Patients need to be advised on sick day rules and this information should be reiterated at every time of patient contact.We conducted an online survey among doctors across all specialties in the Countess of Chester hospital to assess t...

Introduction: Pituitary dysfunction is a recognised complication of traumatic brain injury; it usually involves multiple hormones and can be transient. We present a case of traumatic pituitary haemorrhage resulting in late onset persistent isolated cortisol insufficiency. Case report: A 40 year old man sustained head injury following a road traffic collision. CT brain scan soon after the event was unremarkable. He then developed drowsiness and confusion. MRI scan of the brain ...

Introduction: Hypothyroidism is usually easily treated with levothyroxine tablets. Patients who show poor response to oral therapy are usually found to have inadequate absorption of levothyroxine, or non-compliance. We report a case where intramuscular thyroxine was used successfully in treating a case of resistant hypothyroidism due to possible malabsorption. Case report: A 47 year old lady with primary hypothyroidism, diagnosed aged 34 years, was referred to the endocrine cl...

Introduction: Hypothyroidism in pregnancy may be associated with neurodevelopmental delay of the unborn baby. Timely management of abnormal thyroid function tests (TFTs) in pregnancy is important. In our centre, some patients attend an Endocrinology-led dedicated antenatal thyroid clinic, whilst others attend an Obstetrician-led general antenatal clinic.Objectives: The management of hypothyroid pregnant patients attending our centre was audited against T...

Background: Raised prolactin is a frequent reason for referral to endocrine clinics. Prolactinomas are the most common functioning pituitary tumours. Medical management with dopamine agonists remains the treatment of choice. MHRA advises baseline echocardiograms within 3–6 months and then 6–12 monthly in patients taking dopamine agonists due to a potential risk of cardiac valvular fibrosis though the evidence for fibrosis at endocrine doses remains limited. Aim: The ...

Aim: To compare the use of glitazones against NICE guidelines. (Glitazone recommended as second line therapy in combination with metformin or sulfonyl urea in patients with intolerance or contra-indications to any of the two, not as monotherpay or triple therapy or in combination with insulin).Methods: Patients on glitazone therapy (n=60) were randomly identified from a pharmacy data base from August to December 2006. Retrospective case note revie...

Objectives: To assess the aetiology and management of hyperkalemia amongst inpatients in a district general hospital.Methods: Individuals with hyperkalemia (defined as potassium>6.5 mmol/L) were identified from a biochemistry lab database. Review of case records in a six month period to assess the aetiology and management. Patients on renal replacement therapy and those<18 years were excluded.Results: 45 patients were ident...

Background: Metyrapone is widely used in the UK for the control of cortisol excess in Cushing’s syndrome, but its use is not standardised. There are a few reports published on metyrapone use, mostly containing small patient numbers.Method: A retrospective survey was conducted across 13 tertiary centres. Using a standardised proforma, extensive data including monitoring and safety information were collected for patients with Cushing’s syndrome o...