Endocrine Abstracts

A 70-year-old female presented with general lethargy and a two day history of painful muscle twitching and paraesthesia in her right hand. No other symptoms were reported. Past medical history included hypertension, hypothyroidism and she had recently been diagnosed with Type 2 diabetes. Examination was unremarkable.The overall biochemical picture was that of a hypokalaemic alkalosis with hypocalcaemia and hyperglycaemia: Na+140 mmol/l, K...

Background: Conn’s syndrome accounts for 35% of primary hyperaldosteronism. Elevated plasma aldosterone concentration to renin activity is widely used as a screening diagnostic tool. However, we report an unusual presentation of Conn’s syndrome with normal plasma renin aldosterone ratio.A 48-year-old man was seen in endocrine clinic with uncontrolled hypertension and severe hypokalemia. Primary hyperaldosteronism was suspected with blood pressu...

Introduction: NICE recommends weight loss surgery as a treatment option for people with obesity. However, long term data on outcomes and complications on surgery are limited. We report unexplained adrenal insufficiency post bariatric surgery.Case report: Patient one27 years old lady underwent Roux-en-Y gastric bypass (RYGB). Weight loss (kg) was from 130.2 to 73.2 over a 2-year period. Patient complained of general unwell and dizzi...

Introduction: Obesity is known to be associated with hypogonadotropic hypogonadism. Hypogonadism is an established risk factor for cardio vascular disease and type 2 diabetes mellitus (T2DM). However there is little evidence on improvement in testosterone with bariatric surgery.Aim and methods: To asses changes in testosterone levels after bariatric surgery. Retrospective study on men undergoing bariatric surgery, and data collected pre and post surgery....

Background: Hypercortisol states present a diagnostic conundrum. Other conditions such as cyclical and subclinical Cushings pose additional challenges. We report a complex clinical presentation of thymoma with coexisting subclinical Cushing’s.Case report: A 65-year-old man presented to chest clinic with breathlessness and anterior mediastinal mass on CXR. CT scan demonstrated a 7.5 cm probable thymoma and bilateral adrenal masses of varying sizes up...

We have previously shown that the current guidelines for monitoring thyroid function post radioiodine (RI), may not detect hypothyroidism until it has become severe, in a significant proportion of cases (J Endocrinol Invest 2012 35 82–86). An alternative more intense follow-up strategy was used whereby patients had TSH and FT4 measured at 4-week intervals post RI for 6 months. Endocrine specialist nurse-led telephone and nurse-led out-...

Background: Elevated TSH with raised free T4 (fT4) presents a diagnostic challenge. Symptomatically they vary across the spectrum of thyroid status. We report cases with these dilemmas.Case 1: Seventy four year old was referred with 5 years of TSH ranging between 4.9–7.9 mIU/l (0.2–4.0), fT4 18.5–27 pmol/l (9.0–19) and free T3 (fT3) 4.5–12 pmol/l (2.5–5.7). Thyroid perox...

Introduction: Obesity is known to be associated with hypogonadotropic hypogonadism. Hypogonadism is an established risk factor for cardio vascular disease and Type 2 Diabetes Mellitus (T2DM). However there is paucity on the evidence on improvement in testosterone with bariatric surgery. We report two patients with normalisation of testosterone after bariatric surgery.Case Reports: Patient One 69 year old with BMI 40 and T2DM, hypertension, ischaemic hear...