Endocrine Abstracts

We report the cases of two identical twins with Graves’ disease which proved very difficult to control and followed very similar stormy course. Twin A was a 20 years old female of 12 weeks gestation when she was referred to endocrine clinic with history of weight loss, palpitations and tremor. Her thyroid function tests revealed TSH <0.08 mU/L (0.03–4.30), FT4 82.5 pmol/L (12–22 pmol/L) and FT3 44.4 pmol/L (2.8–7.1) with positive thyroid receptor antibo...

We report the cases of two identical twins with Graves’ disease which proved very difficult to control and followed very similar stormy course. Twin A was a 20 years old female of 12 weeks gestation when she was referred to endocrine clinic with history of weight loss, palpitations and tremor. Her thyroid function tests revealed TSH <0.08 mU/L (0.03–4.30), FT4 82.5 pmol/L (12–22 pmol/L) and FT3 44.4 pmol/L (2.8–7.1) with positive thyroid receptor ant...

We report the case of a 27 year old female who was referred to our diabetes team from the antenatal clinic, when she was found to have an abnormal glucose tolerance at 16 weeks of gestation (fasting and 2 hours blood glucose values of 5.1 mmol/L and 12.2 mmol/L respectively). At the same time she was suffering with severe hyperemesis gravidarum for many weeks and had suffered significant weight loss (thyroid function tests were unremarkable). She had no specific symptoms to su...

We report the case of a 22-year old woman with aggressive Graves disease. She was initially found to be clinically and biochemically thyrotoxic in June-2001 when she presented with severe thyroid eye disease. Treatment was commenced with carbimazole but she failed to adequately comply with therapy and follow-up appointments. She fell pregnant whilst thyrotoxic and was converted to propylthiouracil (dose gradually increased due to poor response). She then left the area and had ...

We report a 44 year old lady with a history of weight loss, anxiety and ‘prominent eyes’. She was clinically and biochemically thyrotoxic (FT4: 158.1 pmol/L [12–22], FT3:56.5 pmol/L [2.8–7.], TSH:<0.08 mU/L [0.30–4.30]). She was commenced on carbimazole and propranolol. Failure to attend regular clinic appointments or comply with drug therapy over the next few years resulted in huge swings of her thyroid status from severe thyrotoxicosis to profoun...

We report two cases of seizures resulting from severe electrolyte imbalance.Case 1: A 48-year old lady with CREST syndrome and oesophageal dysmotility. She was admitted with diarrhoea and vomiting. Routine investigations including FBC, U&E, LFT, and CRP were normal. She later complained of pins and needles in her hands and around her mouth. Twenty-four hours later, she developed blurred vision, neck pain and generalised ache, was found drowsy, with p...

Sexually dimorphic organogenesis of the prostate is a key function of androgens during mammalian development. Mesenchymal AR signalling is essential for prostate development, while epithelial AR is not required. Within the mesenchyme there are distinct mesenchymal subsets that show differential effects of androgens; androgens regulate the thickness of the urethral smooth muscle layer, while in the inductive mesenchymal pad, androgens stimulate branching and growth of prostate ...

Annexin 1 (ANXA1) was first identified as a glucocorticoid (GC)-inducible protein in macrophages and is a mediator of the powerful anti-inflammatory actions of these steroid hormones. In the pituitary ANXA1 plays a critical role in mediating the early-onset negative feedback effects of GCs on the release of ACTH. ANXA1 is expressed in abundance in the anterior pituitary gland where it is localized specifically to the S100-positive folliculo-stellate (FS) cells. GCs act on FS c...

Introduction: We present 3 cases of the same severe electrolyte imbalance presenting with acute neurological symptoms.Case descriptions: Case A, a 48 year old lady with severe CREST syndrome presented with prolonged vomiting and diarrhoea. Initial investigations showed: Sodium 141 mmol/l, Potassium 3.2 mmol/l, Creatinine 53 mmol/l, Glucose 4.3 mmol/l, Haemoglobin 13.9 g/dl, Albumin 38 g/l. 2 days after admission she developed seizures. Case B, a 75 year ...

Objective: Propylthioracil (PTU) when given long term has recently been implicated in the development of antineutrophil cytoplasmic antibody (ANCA) related systemic vasculitis. We describe a case of ANCA positive athropathy induced by long term PTU therapy. Methods: Assessment was based on patient's symptoms, signs, serum markers and treatment outcome as revealed by case notes and patient review. A Medline search for PTU related vasculitis was also performed. Results: A 27-yea...