Endocrine Abstracts

A 21-year-old lady referred for an endocrine review from labour ward HDU after developing polyurea and polydipsia following a difficult labour which was complicated by severe post-partum haemorrhage.She was passing about 500 ml of urine per hour and drinking around ten jugs of water a day. Her bedside observations were stable and her capillary blood glucose level was 4.7 mmol/l. She was referred to ITU where she had a stat dose of IV-desmopressin. Furthe...

A 68-year-old lady presented to hospital with several weeks’ history of paroxysmal symptoms including sweating, pre-syncope and syncope. She also had 2 months history of weight loss. She was a chronic heavy smoker, but did not drink any alcohol and did not take any regular medications.On examination, she appeared cachectic and had a non-tender palpable liver. There were no signs of decompensated chronic liver disease. Her bedside capillary blood glu...

Familial hypocalciuric hypercalcaemia (FHH) is a benign condition, occurs as a result of inactivating mutation in the calcium sensing receptor (CASR) gene and is autosomal dominant.We present a 56-year-old lady with periodic mild hypercalcaemia since 2004. Her highest corrected calcium concentration was 2.76 mmol/l (NR 2.2–2.6). She was asymptomatic. Her parathyroid hormone concentration was also mildly elevated at 9.7 pmol/l (NR 1.6–6.9). Her ...

We present a 71-year-old gentleman who was referred with a 3-month history of tiredness and proximal myopathy, diarrhoea, rapid weight loss and new onset diabetes mellitus.On examination, he had features consistent with cortisol excess including thin skin, abdominal striae, proximal muscle wasting and peripheral oedema to his thighs. Neck examination revealed a palpable 2-cm right-sided thyroid nodule.Laboratory investigations show...

Introduction: Guidelines have, for some time, suggested a lower threshold for surgical intervention in primary hyperparathyroidism based on serum calcium alone. Furthermore, PHPT is a common metabolic bone disorder which is associated with further complications. In order to assess the impact of the lower threshold on surgical services and management implications for associated complications, we report baseline characteristics in a cohort of patients with confirmed PHPT.<p ...

Introduction: Eighty percent of patients with PHPT have co-existing vitamin D deficiency. Few large studies have assessed the impact/safety of different vitamin D preparations on calcium, PTH and vitamin D in such patients. We report the use of three different preparations.Methods: In a retrospective study of 125 patients with confirmed PHPT, 77% were vitamin D deficient (<30 nmol/l)/insufficient (30–50 nmol/l). We assessed the impact and safety...

Introduction: Adrenal insufficiency (primary/secondary) is a rare and potentially life-threatening condition which can be easily overlooked. Patient awareness and management of problems is critical and central to effective treatment. The NICE Clinical Knowledge Summaries for patients identifies and recommends critical areas that require attention in adrenal insufficiency. In particular, patients should:i) Realize the need for lifelong glucocorticoid repl...