Endocrine Abstracts

58 year old man – Mr CBType 2 diabetes for 16 yearsWell controlled hypertensionMicroalbuminuria with ACR 19Persistent haematuria with stone diseaseNo retinopathy or neuropathyNo macrovascular diseaseOtherwise fit and well</p...

Background: Severe hyponatraemia and other electrolyte disturbances secondary to indapamide are documented in the literature. We report two cases that presented with neurological sequelae of profound hyponatraemia without seizures secondary to indapamide.Cases: An 86-year-old female presented with a history of confusion, vomiting and frontal headache associated with lethargy and anorexia. She had been started on indapamide 1 month earlier. She was on no ...

We present here the case of a 33-year-old woman, previously fit and well who presented initially with thyrotoxic symptoms. TFTs showed TSH <0.05, fT3 40. Thyroid uptake scan showed homogenous uptake of 8%. She was prescribed carbimazole 40 mg od and propanolol 40 mg bd with improvement.One month later, she presented to A+E with abdominal pain associated with diarrhoea and vomiting. She was found to be unwell, tachycardic and febrile. She had a global...

Radioiodine is used for the treatment of hyperthyroidism and has been proven to be safe, efficacious and inexpensive. Despite the widespread use, there is a lack of consensus on many aspects of the treatment including aim, radioiodine dose, timing of the second dose and the role of antithyroid medication.This was a retrospective study to investigate the outcome of radioiodine therapy in thyrotoxic patients. The aim was to determine the overall rate of su...

Introduction: The NHS Commissioning Board recommends the introduction of multidisciplinary Tier 3 Specialist Weight Management Services (SWMS) for adults with obesity. Unfortunately, these services are yet to be commissioned in many areas and this largely reflects financial barriers to their development. We have noted, through observation and feedback, that our Tier 3 service is highly valued by patients. Supportive evidence in the literature - although encouraging - is limite...

Background: Obesity is associated with complex multisystem pathology and significant psychosocial burden. Yet, despite its increasing prevalence, the commissioning of Specialist Weight Management Services remains limited.Methods: Retrospective service evaluation of a proportion of patients (n=179) engaging with the Central London Community Healthcare Specialist Weight Management Service for at least 6-months from 2012 onwards. Outcome measures, ...

Previously we reported two loss-of-function dominant negative mutations (P467L, V290M) in human peroxisome proliferator-activated receptor gamma (PPARg) in three individuals with severe insulin resistance, early onset type 2 diabetes mellitus (T2DM) and hypertension. Subsequent detailed clinical and radiological evaluation of these subjects has revealed that each exhibits a stereotyped pattern of partial lipodystrophy affecting the limbs and buttocks. Recently a female with pa...

Background: Nutritional deficiencies are frequently seen in bariatric patients, and typically become increasingly common and resistant following bariatric surgery. Local, national and international guidelines recommend routine blood tests and lifelong supplementation protocols after surgery. Local practice was initially audited for 2013. The purpose of this re-audit was to assess the impact of changes made in the department and to assess concordance with current recommendation...

The nuclear receptor PPARgamma is important for biological processes including adipogenesis and glucose homeostasis. In subjects with severe insulin resistance, we have previously reported two types of human PPARgamma gene defect: heterozygous, missense mutations (P467L, V290M) in the ligand binding domain (LBD) which inhibit wild type (WT) receptor action in a dominant negative manner by recruitment of transcriptional corepressors; or double heterozygosity for a frameshift/pr...