Endocrine Abstracts

Introduction: Primary hyperparathyroidism causes accelerated bone turnover and the consensus is to measure and act upon the 25hydroxyvitamin D level in order to reduce the drive to PTH production, slow down BMD loss, and prevent hungry bone syndrome. How best to replace vitamin D is less clear so we chose to audit our current practice.Method: In 12 months 120 patients with primary hyperparathyroidism were identified retrospectively, 98 of which were vita...

Introduction: It is well-known that prolactinomas sometimes resolve following pregnancy. We wanted to see how often this happens and pregnancy outcome.Patients and methods: From mid 2008 to mid 2013, 66 patients with hyperprolactinemia were studied. 39 had definite microprolactinomas, four probable microprolactinomas, three macroprolactinomas, eight nontumoral hyperprolactinemia and 12 patients were diagnosed elsewhere so no scan results were available. ...

A 20-year-old girl presented to the endocrine clinic with a history of three stone weight gain, and development of numerous purple striae over her lower abdomen, inner thighs and upper arms, gradually progressing over a 12-month period. The onset of symptoms had coincided with the initiation of contraceptive depot medroxyprogesterone acetate, which was discontinued two months prior to her presentation. Her 9 am cortisol was <50 nmol/l.She had a backg...

A 54 year old woman was admitted by her GP to our Medical Admissions Unit earlier this year with a suspected diagnosis of malignancy due to her history of weight loss, lethargy and breathlessness. She was found to be hypercalcaemic with calcium of 3.35 mmol/l. Unfortunately, our acute physicians treated her with pamidronate before her hypercalcaemia was fully investigated which resulted in transient but symptomatic hypocalcaemia (with a nadir calcium of 1.72 mmol/l). A resti...

A 29-year-old woman was admitted at 33 weeks gestation with pre-eclampsia (BP 145/107 mmHg, 3+ proteinuria and significant oedema). On admission her Na was 133 mmol/l and urinary Na 49 mmol/day (ref range 130–260). Twenty-four hours urine protein was 4.43 g/day. Foetal assessment revealed intra uterine growth retardation. She was started on labetolol and the dose titrated upwards to control her blood pressure.Her serum sodium level gradually fell re...

Background: Thyrotoxicosis can be associated with various psychiatric symptoms, such as emotional lability, anxiety, restlessness and rarely frank psychosis. We report such a case.Case report: Forty-seven year old female presented with palpitations, agitation, irritability, itching of her eyes in March 2007. She denied history of tremor or insomnia. No history of drug or alcohol abuse. No personal or family history of depression or any other psychiatric ...

A 76-year-old lady with a background of Crohn’s disease (ileostomy in 1991) was referred to endocrinology in March 2022. Her 9-am cortisol level was <50 nmol/l, with a sodium of 130 mmol/l. These were done as she reported tiredness, lethargy and dizziness since November 2021. She had also lost 7 lb of weight. No evidence of hyperpigmentation. She had then been empirically started on hydrocortisone (10 mg-morning, 5 mg-afternoon and 5 mg-evening) pending evaluation of ...

Introduction: Follicular thyroid cancer (FTC) is a tumour of the thyroid epithelium with follicular differentiation and invasion into capsule or vessels. Constitutes 10% of all thyroid cancers, may be minimally or widely invasive. metastases in 20% of cases by haematogenous spread, rarely to lymph nodes. Twice as common in females as males, mean age 50years. Treated with thyroidectomy, radioactive iodine ablation and TSH suppression with levothyroxine.Ca...

A 67-year-old lady was referred to Haematology for evaluation of Polycythemia (Haemoglobin 162 – 172 g/l, PCV 50 – 53%) A simultaneous referral was sent to Endocrinology for hirsutism, noting that her Testosterone level was 24 nmol/l, SHBG 33 nmol/l. Her past medical history was significant for hypothyroidism, hypertension and migraines for which she was on Levothyroxine, amlodipine and candesartan. She was a non-smoker and teetotaller. Her haematology workup was neg...

Objective: Highlight hypertrophic pulmonary osteoarthropathy (HPOA) and partial HPOA as a cause for raised bony alkaline phosphatase (ALP).Case: We report the case of a 59-year-old lady who was referred to the endocrine clinic with 2 years history of bilateral leg pain and raised bony ALP. She denied any other symptoms. She had no past medical history. She was not on any regular medications and she has never smoked. Apart from mild tenderness over both l...