Endocrine Abstracts

Objective: The MAB, alemtuzumab has been demonstrated to reduce the relapse and the risk of accumulation of sustained disability in multiple sclerosis when compared to β-interferon. The development of autoimmune diseases, including thyroid disease has been reported in the literature with a frequency of 15–25%.Methods: We reviewed the case notes of 39 patients with multiple sclerosis initiated on alemtuzumab in our hospital from 2006 to 2012 and...

A 28-year-old man of Asian origin presented with fever, cough and weight loss over 4 weeks. He had symptoms of worsening headaches and vomiting. The chest X-ray was normal and due to persistent headache and vomiting a lumbar puncture was performed following a normal CT head scan. The CSF findings confirmed the diagnosis of tubercular meningitis and the patient received a complete course of anti tubercular treatment. Six months later he was readmitted with visual blurring, a di...

Background: Recent NICE guidance recommends radioactive iodine as the first line treatment for relapsed thyrotoxicosis as it reportedly produces better control than long-term anti-thyroid drugs (ATDs).However, almost all studies of long-term ATDs relapse occurs after discontinuation of a medication. We present a retrospective analysis of efficacy of ATDs. Methods: Data of all patients with hyperthyroidism, attending Endocrinology clinic at Morriston Hosp...

Background: Metabolic disorders such as type 2 diabetes are risk factors for the development of dementia. In addition to vascular dysfunction, insulin resistance may be important since altered insulin sensitivity is associated with changes in neurogenesis. Polycystic ovary syndrome (PCOS) is a disorder characterised by insulin resistance. Little is known about the impact of metabolic abnormalities on brain structure and function in younger adults.Objecti...

We report two cases with initial presentation of sudden onset ophthalmoplegia in i) a patient recently diagnosed with breast carcinoma and ii) a patient subsequently diagnosed with carcinoma lung. The first patient (68 years) was referred to the tertiary endocrine unit with a 2 weeks history of visual loss associated with 3rd cranial nerve palsy in her right eye and with a temporal hemianopia in her left eye. MRI showed an enhancing sellar and suprasellar mass. Initial biochem...

Introduction: Risk of thyroid cancer is 17-32% in cold nodules and <1 % in hot nodules. Hot nodules are usually associated with Thyrotoxicosis. Patients with thyroid carcinoma are usually euthyroid but may be associated with hypothyroidism. We report 3 patients with hyperthyroidism and associated thyroid carcinoma.Case 1: A 17 years old lady presented with a lump in the neck and examination revealed prominent nodule on the right. TFTs were suggestive...

Introduction: Profound thyrotoxicosis commonly presents with heat intolerance, sweating, weight loss, palpitations, tremor, goitre and eye signs in the case of Grave’s disease. Typically, thyroid storm is differentiated by marked volume depletion, congestive cardiac failure, cardiac arrhythmias, confusion, nausea and vomiting, often with extreme agitation. The wide-ranging and systemic manifestations associated with profound hyperthyroidism are mediated through the thyroi...

Introduction: Pituitary Apoplexy is a rare endocrine emergency which can occur due to infarction or haemorrhage of pituitary gland. Pituitary apoplexy can occur as an initial presentation in patients who are not known to have Pituitary adenomas. Clinical Symptoms vary, however, one should have a high index of suspicion if symptoms such as acute headache, visual loss or ocular palsy occur.Precipitating factors: Hypertension, Preganancy, Head trauma, Dynam...

Background: Phaeochromocytomas (PHAEOs) and paragangliomas (PGLs) are rare catecholamine producing tumours which are potentially lethal if left untreated and may be associated with a wide variety of complications. Optimum management demands multidisciplinary input from endocrinologists, biochemists, geneticists and endocrine surgeons.Objective: A retrospective audit into the management of PHAEOs/PGLs at our institution against the 2005 recommendations ma...

Background: The screening investigation of choice for phaeochromocytomas (PHAEO) and paragangliomas (PGL) in the UK is usually a 24 h urine collection for fractionated metadrenalines +/− free catecholamines. These assays have high diagnostic sensitivity (approaching 98%) but lower specificity.Aim: To review causes of false positive (FP) catecholamine and metabolite results in our centre over a 12-year period.Methods: Data wer...