Endocrine Abstracts

Background: Graves disease is the most common cause of hyperthyroidism or thyrotoxicosis in children. The prevalance is 1 in 10 000 among children. It is important to reinforce the awareness amongst clinicians as patients can present with wide range of clinical symptoms. The range of presentations in our study included a child treated for one year for Attention Deficit Hyperactivity Disorder (ADHD) to a child who had diarrhoea and abdominal pain and presented as appendicitis i...

Background: Diabetic ketoacidosis (DKA) can have significant morbidity and mortality in children and young people (CYP). Its management is very well standardised, based on National Guidance (National Institute of Clinical Excellence – NICE). In the UK, CYP DKA Guidelines have been reviewed in 2015 in order to reduce the risks of cerebral oedema. There have been concerns that the new recommended fluid management has the potential to increase the risk of acute kidney injury...

Introduction: The incidence of type 1 diabetes (T1DM) is increasing, affecting approximately 1 in 500 children and young people (CYP) under 19 years of age. The diagnosis of diabetes, as well as initial investigations and management is standardised, based on national guidance. Initial education and management have huge importance for long-term glycaemic control. We review the practice in our hospital, to establish our compliance and any deviations from the guidelines. We also ...

Thyroid eye disease (TED) affects some 400 000 people in the United Kingdom. Apart from being problematic and cosmetically distressing to patients it can be occasionally sight threatening. The joint TED clinic was first established at the New Cross Hospital in 2010. At this monthly clinic patients are assessed by both an Endocrinology and Ophthalmology consultant. Full orthoptic evaluation is done and the management plan is facilitated by a patient self-assessment questionnair...

Annual reports have been provided to the UK Acromegaly Database on 72 patients seen in Aberdeen during the past decade (41 women, mean age at diagnosis 47 yrs, mean GH at diagnosis 59 mU/l and 60% with macroadenomas). Thirty percent had glucose intolerance and 33% hypertension. Fifty-eight percent underwent surgery, 36% external radiotherapy (XRT, either alone or as adjuvant therapy) and 17% primary medical therapy (PMT, 4 had declined surgery). Thirty-seven percent are curren...

A 12-year-old girl was referred to the endocrinology clinic for investigation of short stature. She had signs of early puberty yet had precocious menstruation associated with menorrhagia. She gave a recent history of recurrent epistaxis. There was no family history of a bleeding disorder. She reported cold intolerance, dry skin and a tendency for hair to fall.On examination she was pale with no evidence of purpura or significant bruising. There was no en...

Introduction: Adrenal schwannomas are rare but important causes of adrenal tumours which can often only be diagnosed histologically. We present an interesting case of an incidentally detected adrenal schwannoma.Case: A 67-year-old gentleman had an ultrasound imaging of the abdomen that incidentally revealed a large right adrenal mass prompting referral to the endocrinology service. His past medical history included myoca...

Introduction: Diabetic ketoacidosis (DKA) remains a common presentation of type 1 diabetes (T1D) in children. During the COVID-19 pandemic, rates of presentation in DKA increased. Electrolyte abnormalities can occur during DKA treatment, but they are uncommon at presentation. We report a teenage girl with new-onset T1D presenting in severe DKA, complicated by profound hypokalaemia and hypernatremia. Case Report: A previously healthy 13-year-old girl was ...

There is scant literature on various mental health parameters following treatment of hyperthyroidism. We present our initial results from an ongoing quality improvement project, jointly undertaken by the Endocrinology and Psychiatry teams.Aim: To evaluate anxiety, depression, ability to work and quality of life (QOL) of patients with hyperthyroidism on presentation and after institution of specific therapy.Method: We assessed 68 ne...

Background: Although, the diagnostic accuracy of magnetic resonance imaging (MRI) has increased in recent years, it may fail to detect secretory adenoma in a few patients with GH excess. Managing such patients with acromegaly can be challenging. We present a case where 11C-methionine PET/CT co-registered with SPGR/volume MRI proved to be helpful in identifying GH secreting pituitary adenoma.Case history: A 42-year-old male was referred by surg...