Endocrine Abstracts

Bariatric surgery has emerged as an effective tool for people with severe obesity and type 2 diabetes. A 38 years old lady with type 2 diabetes for 10 years and a BMI of 51 kg/m2, underwent bariatric surgery (Roux-en-Y gastric bypass). Other past medical history includes hypertension and hyperlipidemia. She was diagnosed with gestational diabetes in her 1st pregnancy and type 2 diabetes in subsequent pregnancy. She has lifelong problems with her weight. D...

Gonadal dysgenesis with DAX1 duplication as the cause of XY disorder of sexual development is a rare condition. Duplication of this causes male to female sex reversal while mutation or deletion can cause adrenal hypoplasia congenita with hypogonadotropic hypogonadism. We present a case of 37-year-old lady who was referred to endocrine clinic with ongoing symptoms of fatigue. She was diagnosed with 46 XY gonadal dysgenesis when she presented with groin swelling at the ...

Introduction: Kikuchi-Fujimoto disease (KFD) is a benign self-limiting disease presenting with fever and lymphadenitis and mostly affecting adults younger than 40 years of age and of Asian descent. Its aetiology and pathogenesis are unknown though KFD often occurs in patients with concomitant autoimmune illness such as autoimmune thyroiditis or lupus erythematosus (SLE). We report a case of a patient with KFD and fluctuating thyroid function and thyroid autoantibody levels.</p...

Introduction: Hyperprolactinaemia is a common finding in endocrine practice and can be due to a number of causes. The degree of elevation of prolactin levels may sometimes be helpful in distinguishing between underlying aetiology.Aim: To determine if hyperprolactinaemia is correlated with clinical diagnosis in a cohort of patients in the endocrine service at a tertiary centre.Methods: A biochemistry database held at University Hosp...

Introduction: Endocrine society guidelines advocate early colonoscopy and monitoring for acromegaly-associated complications and recurrence. We aimed to establish whether people with acromegaly under our care received appropriate monitoring.Methods: Patients under follow-up with acromegaly diagnosed 1989-2021 were included. Electronic health records were accessed for clinic letters, colonoscopy reports, blood and imaging results from the diagnosis to rec...

Introduction: Levothyroxine, the standard therapy for hypothyroidism, is usually well tolerated and very few cases of true allergy to levothyroxine have been reported to date. Here we report two cases of rare occurrence of levothyroxine allergy.Case 1: A 56-year-old woman with no previous history of allergies started levothyroxine post-thyroidectomy for Graves’ disease. She developed facial flushing and urticarial rash within 15 minutes of the first...

Introduction: Graves’ disease, a common cause of hyperthyroidism, occasionally poses therapeutic challenges. This case report highlights complexities of Graves’ disease management, particularly an unusual complication: Propylthiouracil (PTU) - induced ANCA vasculitis.Case report: A 51-year-old lady with Graves’ disease diagnosed in 2008, achieved remission with 18 month course of Carbimazole. She experienced a relapse in February 2021 and ...

A 41 year old gentleman presented with collapse and vomiting for one week was found to be hyponatraemic with sodium of 103. He was treated with a sodium chloride 0.9% over 100 ml/hour and once sodium was increased to 118 in less than 24 hours. He was deescalated from intensive care on day3. He had developed severe ataxia, slow speech and was highly emotional. He was previously high functioning, maintaining a job and independent. It had transpired that he had been drinking 18 c...

Introduction: Thionamides are the mainstay of management of thyrotoxicosis but can be associated with adverse effects like agranulocystosis, hepatitis and vasculitis. While radioactive iodine and thyroidectomy can be utilized in such scenarios, they were not timely available during the COVID pandemic. We present our experience of using cholestyramine as monotherapy.Case Series: Our series consists of four females. Graves’ disease was the underlying ...

Levothyroxine, the standard therapy for hypothyroidism, is usually well tolerated and very few cases of true allergy to levothyroxine have been reported to date. In these cases mechanisms have not been conclusively identified but have been hypothesized to be allergies to excipients. Here we report a rare occurrence of levothyroxine allergy and the effectiveness of desensitization. A 56-year-old lady with no previous history of allergies required a total thyroidectomy for Grave...