Endocrine Abstracts

A 25-year lady was referred by her GP with a six-month history of symptoms suggestive of thyrotoxicosis; weight loss, palpitations, heat intolerance and lethargy. She also complained of thirst, polyuria and nocturia. Examination findings included tachycardia, tremor and a moderately enlarged goitre.In clinic, blood tests performed confirmed thyrotoxicosis: TSH<0.05 mU/l (NR 0.3–4.2 mU/l), free T3 >46.1 pmol/l (NR 2.5–5.7 pmol...

A 42-year-old gentleman of Ghanaian origin presented with a one month history of worsening severe proximal myopathy. On presentation his symptoms had progressed to the extent that he was unable to mobilise from his bed. Prior to this illness he had been fit and well. Examination revealed severe proximal myopathy and a uniformly enlarged, smooth thyroid gland. There was no clinical evidence of hyperthyroidism. Blood tests on admission showed a serum potassium level of 2.1 mmol/...

A 31-year-old engineer presented with a 6-week history of tremor, weight loss, mild goitre and palpitations. At the onset of these symptoms, he also presented to a specialist eye hospital for difficulty with focussing his vision. He had no past medical history and was taking no medications. He did not have any family history of ocular or autoimmune conditions and was a non-smoker. On examination his BMI was 20, he had very mild proptosis, no diplopia and a diffuse symmetrical ...

A 47-year-old afrocaribbean lady was referred to endocrinology clinic with a 1-month history of weight loss, heat intolerance, palpitations, fatigue and hair loss. She reported symptoms consistent with proximal myopathy including myalgia and difficulty rising from chairs. Interestingly she noted a 1-month history of hypersalivation, which had caused her significant distress in her social and work life. The hypersalivation had resulted in a change in her voice and had also inte...

A 19-year-old man was referred to Endocrinology Clinic with a minimally raised calcitonin level. He had a past history of primary hyperparathyroidism resulting in renal colic aged 17 years, and underwent three gland parathyroidectomy aged 18 years. Histology demonstrated a single right lower parathyroid adenoma with normal thyroid biopsy. He has no family history of endocrine disease and is a non-smoker. His calcium has remained normal since with detectable PTH. Over 5 years t...

Introduction: Neonatal hypoglycaemia (NH) is common in infants born soon after betamethasone administration, and may be reduced by at-target peri-partum glycaemic control. A Pregnancy-specific Intravenous Insulin-Glucose Infusion (PIIGI) protocol was introduced at a tertiary hospital in June 2017, replacing a generic Adult IntraVenous Insulin protocol (AIVI) not designed for pregnancy, without change in indication for IV insulin (initiated with any BGL>6.7 mmol/L following...

A 31-year gentleman presented with a four day history of anxiety and confusion. Over several months, he had noticed red eyes and a ‘stomach-ache’. A collateral history revealed a previous episode of confusion and concern about excessive alcohol intake. He denied any current medication. On examination, he had bilateral conjunctivitis. Investigations demonstrated severe hypercalcaemia of 3.54 mmol/l (NR 2.15–2.6 mmol/l). He was treated with intravenous fluids and ...

Nesfatin is an 82 amino acid peptide identified as a novel hypothalamic regulator of feeding. In rodents, central administration of nesfatin acutely inhibits feeding and chronic administration reduces weight gain. Subsequent research has demonstrated nesfatin is involved in the control of puberty in female rats. During puberty i.c.v. administration of nesfatin stimulates release of LH and FSH but has no effect in adult female rats.We investigated the eff...

We present the case of a 33-year-old woman diagnosed with congenital adrenal hyperplasia (CAH) due to classical 21-hydroxylase deficiency following a salt-losing crisis as a newborn. She had previously been controlled on dexamethasone 0.25 mg bd and fludrocortisone 100 mcg od, as evidenced by high-normal 17-hydroxyprogesterone (17-OHP) and low-normal testosterone levels (8.5 and 0.4 nmol/l respectively).However, she had experienced significant symptoms o...