Endocrine Abstracts

Aim: To compare the efficacy, tolerability and safety of high doses of i.m. vitamin D2 (ergocalciferol) with oral vitamin D3 (colecalciferol) supplementation in women with low vitamin-D levels.Design and settings: Of 107 patients (s25(OH)D≤50 nmol/l), aged 21–89 years were recruited in a retrospective audit. Participants were separated in two groups according to serum vitamin D levels. The Group 1 included individuals wit...

A 32-year-old lady was referred to our centre with thyrotoxicosis and elevated FT4 and TSH levels. She was already on carbimazole. Interestingly, her symptoms started at childhood. She was nicknamed ‘shaky’ by her school friends because of her tremors. There was no family history of thyroid disease.She was clinically and biochemically thyrotoxic with FT4 of 12.4–38.8 pmol/l and TSH of 7.24–38.8 mIU/l.<p class...

The efficacy of dopamine agonist therapy for complex solid and cystic macroprolactinoma is a subject of controversy among endocrinologists. Many believe that such therapy may not result in a clinically significant shrinkage of any cystic component of a macroprolactinomas.We present a case of cystic macroprolactinoma which responded damatically to dopaminergic therapy with recovery of pituitary function.A 22 years old male, presente...

Growth hormone replacement has not been recommended for use during pregnancy, due to lack of controlled trials to study its effects on the mother and the baby. We present a patient with hypopitiutarism on rhGH replacement which was continued during pregnancy with no adverse effects.A 35 years old lady, diagnosed ages 30 with pan-hypopituitarism secondary to non-functioning pituitary adenoma, she underwent trans-sphenoidal resection of the adenoma in 2002...

Nebido (testosterone undecanoate, 1000 mg) is a new, long acting, intramuscular (IM) preparation of testosterone (T) that can be administered every 10–14 weeks. We conducted a study to evaluate the factors that influence serum T levels after commencing Nebido and may therefore help clinicians estimate dosing frequency for this therapy.Following the recommended loading regimen, 51 hypogonadal men (35, 68.6% secondary hypogonadism) had two injections ...

Introduction: In young patients with Primary hyperparathyroidism, parathyroidectomy is the treatment of choice. Transient hypocalcaemia is common complication of parathyroidectomy but rarely potentially life threatening hungry bone syndrome (HBS) can develop. HBS is a state of hypocalcaemia, hypophosphataemia and tetany without concomitant hypoparathyroidism, and is caused by massive calcium deposition to the bone. Resulting hypocalcaemia can be severe and prolonged, requiring...

It is important when initiating intramuscular Nebido (testosterone undecanoate) to monitor the serum testosterone level to ensure physiological replacement is achieved. Following a loading regimen of Nebido the manufacturer recommends measuring testosterone levels to determine the frequency of subsequent injections.We conducted a retrospective study of 36 hypogonadal men [12 (33%) primary hypogonadism, 24 (67%) secondary hypogonadism] to establish what f...

There are a number of symptomatic patients with hypothyroidism who fail to normalise thyroid function (TFTs) despite large doses of thyroxine (LT4) replacement. Non-compliance is a common cause of treatment failure even in patients who strongly deny this. To avoid unnecessary and prolonged investigations for other causes we advocate a simple protocol to manage this problem. Patients are observed taking 1000 mcg of LT4 at 09.00 hrs, and have hourly Free T4 and TSH levels measur...

Background: Conn’s syndrome accounts for 35% of primary hyperaldosteronism. Elevated plasma aldosterone concentration to renin activity is widely used as a screening diagnostic tool. However, we report an unusual presentation of Conn’s syndrome with normal plasma renin aldosterone ratio.A 48-year-old man was seen in endocrine clinic with uncontrolled hypertension and severe hypokalemia. Primary hyperaldosteronism was suspected with blood pressu...

We present a 20-year-old lady who was known to have MEN-1 and had previously been treated for hyperparathyroidism at a different hospital in 2003 with excision of right upper and lower and left lower parathyroid glands and left thyroid lobectomy, resulting in normalisation of adjusted calcium (adjCa) levels.She presented to our department with persistently elevated adjusted calcium levels (adjCa 2.69 mmol/l) along with raised parathyroid hormone (PTH 16 ...