Endocrine Abstracts

The role of environmental and occupational toxins in the aetiology of unexplained infertility remains to be fully explored. Epidemiological studies have implicated heavy metals, including cadmium as having a pathogenic role with studies demonstrating associations between serum levels, testicular function and gonadotrophin levels in large cohort studies. Cadmium toxicity is associated with a complex spectrum of effects. Whilst the renal complications are well described, putativ...

Hyperthyroidism complicates ~1 in 1000–2000 pregnancies, with majority of cases due to Grave’s disease (GD). PTU remains the preferred ATD of choice in pregnancy with carbimazole a reasonable second-line alternative in patients allergic or intolerant to PTU. We present the case of a lady with PTU induced agranulocytosis in pregnancy.A 29-year-old lady was seen in thyroid clinic in May 2006 having had symptoms suggestive of thyrotoxicosis since ...

We present a case of primary hyperparathyroidism in a pregnant woman presenting with recurrent vomiting.A 34 year-old Asian woman was admitted with nausea and vomiting at 8 weeks gestation. Clinical examination was unremarkable apart from dehydration. Electrolytes and thyroid function were within normal limits. A diagnosis of hyperemesis gravidarum was made and patient was discharged after rehydration. Over the next eight weeks she presented with similar...

Background: The PCSK9 inhibitors (PCSKi), evolocumab and alirocumab, were approved by NICE in 2016, and have since proved to be efficacious in lowering LDL-C. Yet little is known about their long-term adverse effects. Genetic studies have shown patients with PCSK9 loss-of-function variants are at increased risk of T2DM. Similarly, analyses of an adverse event database found increased reports of PCSK9i-related hyperglycaemia. Meta-analyses have suggested that P...

Case Presentation: 37-year-old woman of South Asian origin was referred from retinopathy screening to our diabetes clinic for evaluation of an unusual finding during her retinal screen. Her retinal blood vessels appeared white in contrast to normal pink to red colour. She was recently diagnosed with type 2 diabetes and with type 1 hyperlipidaemia (T1 HPLA) confirmed by genotype for more than 10 years for which she had suboptimal control with multiple hospitalisations with recu...

A 59-year-old lady was admitted with lethargy and dehydration in October 1998 and investigations confirmed primary hyperparathyroidism with corrected calcium 4.49 mmol/l (N: 2.1–2.6). After fluid resuscitation, she underwent parathyroidectomy and biopsy revealed parathyroid hyperplasia. Post-operatively, her calcium remained normal until November 2000 when her corrected calcium was 3.05 mmol/l with PTH 311 ng/l (N: 12–65). Sestamibi scan failed to local...

Protein tyrosine phosphatases (PTPs) such as PTPN22, that encodes lymphoid tyrosine phosphatase (LYP), are important regulators of cell signalling. LYP, through interaction with various accessory molecules including Grb2 and Csk kinase, has been shown to be particularly important in regulating signal transduction from the T cell receptor. The identification of PTPN22 as a susceptibility locus for Graves’ disease (GD) led us to hypothesise that other PTPs may...

Section 1: Case history: A 37-year-old South Asian woman was referred to our diabetes clinic from the Diabetes Eye Screening Programme. Her retinal blood vessels appeared white, in contrast to the normal pink-red colour. The patient was diagnosed with diabetes secondary to chronic pancreatitis a year prior to this presentation, for which she was on metformin and long-acting insulin but had suboptimal control and multiple hospitalisations with chronic pancreatitis. She was prev...

Background: With increasing ethnic diversity in the Western World, it is important to establish the safety of religious practices such as fasting during Ramadan. There is limited information about severity and outcome of diabetes-related ketoacidosis (DKA) during Ramadan outside Middle East.Objective: We studied differences in severity, DKA-related complications and outcomes of DKA before (Shaban), during (Ramadan) and after Ramadan (Shawwal).<p clas...