Endocrine Abstracts

Aim: To evaluate the outcomes of radioactive iodine therapy (RAI) in benign thyroid disease following implementation of 2007 Royal College of Physicians (RCP) guidelines in a large NHS foundation trust.Method: The medical records of patients referred for RAI therapy at Sheffield Teaching Hospitals (UK) between 2013 and 2015 were retrospectively reviewed. Patient data was collected from patients’ notes and electronic documents system. The data record...

A 69-year-old retired pharmacist was referred to our endocrine clinic with an incidental finding of hypokalaemia noted during recent spinal fusion surgery. He has been hypertensive for 6 years. His blood pressure was well controlled on Diltiazem 240 mg and Doxazosin 4 mg, but required 8 tablets of SandoK daily to maintain normokalaemia. His past medical history includes type 2 diabetes, diabetic retinopathy, chronic kidney disease, hypercholesterolaemia and benign prostatic hy...

Case history: A 26 year-old lady was admitted from clinic with severe hypertension and bilateral papilloedema. Six weeks prior to admission she had undergone resection of a massive right upper quadrant lesion that was felt to be of hepatic origin. Histological analysis of the lesion revealed it to be an adrenal phaeochromocytoma and she was thus referred to the endocrine service. Pre-operative biochemical assessment had not been performed but there was no evidence of any blood...

Background: Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is an autosomal recessive inherited disorder resulting in the inability to breakdown medium-chain fatty acids to provide energy during periods of low-calorie intake and hypoglycaemia (infections, fasting, vomiting). Without urgent treatment, the accumulation of toxic fatty acids leads to encephalopathy and sudden death.Pregnant females with Type 1 diabetes requ...

Background: Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is an autosomal recessive inherited disorder resulting in the inability to breakdown medium-chain fatty acids to provide energy during periods of low-calorie intake and hypoglycaemia (infections, fasting, vomiting). Without urgent treatment, the accumulation of toxic fatty acids leads to encephalopathy and sudden death.Pregnant females with Type 1 diabetes requ...

Lactate is a metabolite that activates the G-protein coupled receptor, Hydroxycarboxylic acid Receptor 1 (HCAR1) to regulate physiological processes such as lipolysis, cancer cell survival, and neuroprotection. Lactate exists in two forms, L+ and D-, with the L isoform predominant in the human body. Interestingly, both isoforms are only found together in the gastrointestinal tract. L-lactate is synthesised as a by-product of anaerobic respiration, whereas D-lactate, is a produ...

Introduction: Somatostatin analogues (SSA) are a cornerstone in the treatment of neuroendocrine tumours. Two clinical trials have defined the disease control effect of these treatments; the PROMID study of Octreotide LAR v’s placebo, median time to tumour progression (TTP) 14.2 m v’s 6.0 m, and the CLARINET study (Lanreotide v’s placebo), median progression free survival (PFS) 31 m v’s 18 m. In every day practice, however, many neuroendocrine tumours commen...

Background: Aldosterone producing cell clusters (APCCs) are microscopic pockets of cells in the adrenal zona glomerulosa (ZG), which stain densely for aldosterone synthase (CYP11B2). They exist in 30% of normal adrenal glands and have similar somatic genetic mutations as some aldosterone producing adenomas (APA), especially of CACNA1D. Some APCCs are precursors to APAs. Adrenalectomy for primary aldosteronism (PA) cures hypertension in < 50% of patients, maybe bec...

Introduction: Primary skeletal muscle lymphomas are extremely rare, accounting for less than 1% of extra-nodal lymphomas.1 Hypercalcaemia is a common reason for admission to hospital. There are four main mechanisms by which neoplasms can cause hypercalcaemia; secretion of parathyroid hormone-related peptide, osteolytic metastases, (rarely) ectopic PTH secretion, and expression of 1 alpha hydroxylase, causing excess activated vitamin D and gastrointestinal absorption...

A 53 year old male with a history of polysubstance abuse was admitted to A&E, having been found unconscious in the community with a blood glucose level of 1.2 mmol/l. Despite intramuscular glucagon and intravenous 20% dextrose administration, his blood glucose was confirmed to be 2.6 mmol/l on arrival in A&E. Neuroglycopaenia was refractory to multiple dextrose boluses and only stabilised following a continuous 20% 125 ml/hr dextrose infusion. Following admission to th...