Endocrine Abstracts

Type 1 diabetes mellitus is usually believed to present acutely and it is assumed that metabolic decompensation is sudden.We present 3 cases of asymptomatic type 1 diabetesCase1A 28 year old asymptomatic gentleman moved to a new surgery and glycosuria was noted as part of routine screening , no ketonuria., body mass index 21, no past medical illness or any family history of diabetes. His fasting blood glucose...

Reactive hypoglycaemia is usually mild, often presents with non-specific symptoms and may be difficult to distinguish from neuropsychiatric illnessThe diagnosis should be considered when these symptoms are related to eating. We present a severe case of idiopathic hypoglycaemia which responded dramatically to the alpha-glucosidase inhibitor acarbose.A 25 year old woman presented with a nine year history of intermittent thirst, feeling hot, distal paraesth...

A 54yr old female presented with a 12-month history of tremor, sweating, anxiety and occasional palpitations. There was no past medical or family history of note. On examination, she had a fine tremor but no neck masses or eye signs. Her FT4 20.8 pmol/l (8pmol/l-22pmol/l), FT3 7.3 pmol/l (3.5-6.5pmol/l) with a suppressed TSH less than 0.01mu/l (0.35mu/l-5.5mu/l); 99Tc scan showed an autonomous hot nodule in the right lower lobe of the thyroid with partial suppression of the re...

We report the management of 16 predominately elderly patients (12 female: 2 male; mean age at presentation 73.8 years, range 48 to 85 years) presenting with massive goitres. Seventy-five percent had significant co-morbidities. Fifteen had multinodular goitres and 1 Reidel’s thyroiditis. Four goitres were confined to the neck; 6 were intra-thoracic and 6 had both neck and intra-thoracic goitres. Five had symptoms of compression; 9 were thyrotoxic and 2 hypothyroid. Mean fo...

Chronic fatigue syndrome (CFS) is a common and disabling problem; although most likely of biopsychosocial origin, the nature of the pathophysiological components remains unclear. Most studied has been the hypothalamic-pituitary-adrenal (HPA) axis; although the quality of many studies is poor, the overall balance of evidence points to reduced cortisol output in at least some patients, with some evidence that this is linked to symptom production or persistence. However, there is...

Subcutaneous heparin is commonly used for prophylaxis of deep vein thrombosis. Heparin induced hypoaldosteronism can lead to hyperkalemia and natriuresis. These side effects are more common in elderly, renal insufficient and diabetic patients. We present a case with heparin induced hyperkalemia in a patient with diabetes.An 85 year old lady with insulin dependent diabetes mellitus of 32 years duration with peripheral neuropathy was admitted under the vas...

Ghrelin, a circulating gastric hormone, stimulates food intake in rodents and humans and hyperphagia, weight gain and adiposity on chronic administration in rodents. Here we investigated the effect of chronic subcutaneous ghrelin on fat volume and distribution using magnetic resonance imaging (MRI). Male Wistar rats were implanted with subcutaneous osmotic mini-pumps delivering saline (S, n=10) or ghrelin 30nmol/24hours (n=18). In order to investigate the hyperphagia-independe...

Background: CSF rhinorrhoea is a rare but recognised complication of dopamine agonist therapy for macroprolactinoma. In the majority of cases, onset of CSF rhinorrhoea is within 4 months of commencing therapy.Case report: A 23-year-old man presented to the Emergency Department in April 2010 with acute weakness in his left arm and leg associated with intermittent headaches. Examination revealed mild right-sided ptosis and inadequate androgenisation. Visua...

Background: The BTA guidelines for the use of thyroid function tests recommend the measurement of TSH receptor antibodies (TRAb) when investigating hyperthyroidism of uncertain aetiology, in suspected Graves’ ophthalmopathy and in pregnant women with Graves’ disease. An in-house TSH receptor autoantibody ELISA assay (TRAb) was introduced in 2008. This study has audited the assay performance and evaluated its clinical usefulness in a tertiary centre.<p class="abst...