Endocrine Abstracts

A 50-year-old peri-menopausal lady has had a background history of hypertension on single-agent antihypertensive medication (ACEI), chronic headache, recurrent collapses, and panic attacks for the past 14 years. She has been visited by her GP frequently and performed countless blood tests including FSH, LH, and TSH which confirmed that her symptoms were neither related to menopause nor hyperthyroidism. She also presented to the Emergency Department a dozen times and called par...

A 51-year-old gentleman who has been diagnosed with bilateral pheochromocytoma at the age of 11 after developing classical symptoms of catecholamine excess and had bilateral adrenalectomy. At the age of 37, he underwent total thyroidectomy with preservation of the parathyroid glands for C-cell hyperplasia. Over the course of the years, it was presumed he had MEN2A syndrome, although no formal genetic testing was done. He does not have a family history of MEN syndrome and does ...

A 17-year-old young lady presented with tiredness, weight loss, palpitations, hot flushes and irregular menstruation in April 2016 and her initial TFTs showed TSH <0.03 mU/l with a fT4 of 48.2 pmol/l. She was treated with carbimazole 40 mg daily and further investigation confirmed she had had Graves’ disease as TSH receptor antibodies (2.10 U/l), TPO antibodies (>1300 IU/ml), thyroid ultrasound scan demonstrated mildly enlarged and thyroiditis. She had only six period...

A 50-year-old peri-menopausal lady has had a background history of hypertension on single-agent antihypertensive medication (ACEI), chronic headache, recurrent collapses, and panic attacks for the past 14 years. She has been visited by her GP frequently and performed countless blood tests including FSH, LH, and TSH which confirmed that her symptoms were neither related to menopause nor hyperthyroidism. She also presented to the Emergency Department a dozen times and called par...

Background: Adrenal incidentalomas often pose a clinical conundrum when identified radiologically. The direction of management is often based on findings on imaging and biochemistry. To aid management, the European society for Endocrinology (ESE) recently published guidelines. Aims and Methods: We conducted a retrospective analysis of 142 patients with identified adrenal incidentalomas between April 2020 and April 2021 in East Kent Hospitals University N...

An 87-year-old lady was admitted to hospital with severe unexplained hypoglycaemia with capillary glucose of 1.8 mmol/l and went on develop recurrent episodes of symptomatic hypoglycaemia during this admission. She had a background history of diabetes mellitus, well under controlled with diet and a previous diagnosis of solitary fibrous pleural tumour of left lung, which was resected completely in 2013 but reoccurred in 2022 with left sided pleural effusion. Her liver and rena...

An 87-year-old lady was admitted to hospital with severe unexplained hypoglycaemia with capillary glucose of 1.8 mmol/l and went on develop recurrent episodes of symptomatic hypoglycaemia during this admission. She had a background history of diabetes mellitus, well under controlled with diet and a previous diagnosis of solitary fibrous pleural tumour of left lung, which was resected completely in 2013 but reoccurred in 2022 with left sided pleural effusion. Her liver and rena...

A 54-year-old gentleman presented to his GP in July 2019 with significant weight loss, polyuria and nocturia for two to three months. His HbA1c was 78 mmol/mol. He was diagnosed with diabetes and started on Metformin 500 mg BD. Upon consultant review in September 2019, he reported a 26 kg weight loss over the preceding four years, much of which was apparently intentional, and right abdominal discomfort. His paternal grandmother died of pancreatic cancer, as did his paternal au...

A 74-year- old gentleman was found to be hyponatraemic when he returned from birds watch trip with cellulitis of lower legs. He was generally fit and well apart from hypertension for which he had been on Amlodipine and Irbesartan. He was admitted with severe hyponatremia in July 2019 and was diagnosed with idiopathic SIADH as evidence of low serum osmolality (252 mosm/kg), high urine sodium (41mmol/l) and high urine osmolality (657mmol/kg). His Amlodipine and Irbesartan were r...

A 44 years old lady was reviewed by endocrinology team in January 2020 for weight gain, increased fat deposition around the neck, constant fatigue and decreased libido. She denied usage of exogenous steroids. She was normal BMI, normotensive and did not display signs of Cushing’s syndrome in first visit. Although overnight dexamethasone suppression was failed to suppress: cortisol of 141 nmol/l and ACTH 78 ng/l, Low dose dexamethasone suppression test (LDSST) was adequate...