Endocrine Abstracts

Introduction: The incidence of primary hyperparathyroidism (PHPT) is ~3.5/100 000 per yearThe incidence is on the rise due to increase in ‘routine biochemical testing’Has been thought to be a ‘relatively harmless’ disorder.Some patients tend to undergo surgery, while others are conservatively treated and most followed up for a short period before discharge from follow up.Aims:<l...

Introduction: Hypocalcemia in post-operative hypoparathyroidism responds to oral vitamin D and calcium replacement. We describe a case of persistent symptomatic hypocalcemia and hypothyroidism despite oral replacement and management with supervised weekly supplementation.Case history: A 56-year-old lady had total thyroidectomy for multinodular goitre. Persistent post-operative hypoparathyroidism and hypothyroidism necessitated replacement with calcitriol...

We report the case of a 70 year-old-lady with a background of type 2 diabetes and hypertension who was admitted with a history of self-neglect. She had burns affecting her hands which she had sustained after falling asleep next to the fire five weeks previously. Over the preceding three months, the patient had also deteriorated in terms of self-care, appetite, mobility and control of her blood sugars.On examination, the patient was noted to have severe u...

We present an unusual cause for symptomatic hypopituatism presenting due to a metastatic deposit. A 77 year old smoker and ex-miner was admitted with a 3 week history of breathlessness, malaise and weight loss. He had clinical evidence of a severe pneumonia but also had clubbing, was hypotensive, hypothermic and hypoglycaemic. He had no clinical features of Addison’s disease, no neurological symptoms or signs and a normal breast examination. Chest X-ray suggested extensiv...

We report the case of a 42-year-old transsexual with Di-George syndrome (DGS) presenting in adulthood with profound hypocalcaemia and personality disorder. The patient had multiple hospital admissions with episodes of deliberate self-harm and recurrent seizures. Routine investigations revealed hypocalcaemia secondary to hypoparathyroidism. The diagnosis of DGS was delayed until six years later. The clue to the underlying condition was the finding of DGS in the patient’s d...

We present 2 cases of extraadrenal phaeochromocytoma with several unusual features: (a) A 54 year-old female presented with dizziness, falls, and palpitations. She was tachycardic with blood pressure of 218/75 supine and 139/107 standing. An abdominal mass was palpable. Urinary catecholamines were markedly raised and a CT scan showed para-aortic mass with avid MIBG uptake confirming the diagnosis of an extraadrenal phaeochromocytoma. Persistent hypokalaemia and hyperglycaemia ...

Background: The most significant hypotheses regarding biological causes of transsexualism are based on the role of environmental hormonal exposure on neural development.Aim: This study was to analyse the baseline hormonal results in a population of transsexuals attending a single clinic to identify any abnormalities in hormone levels in these individuals.Method: A retrospective cohort study was carried out using data collected from...

Background: Transsexuals in Britain are prescribed hormones as part of Gender Reassignment Treatment. Oestrogen therapy is associated with the development of deep vein thrombosis (DVT) with a 25 fold increased risk, and breast cancer; particularly in the older age group and smokers.Aims: To investigate the risk of developing deep vein thromboses in male to female transsexual patients who are, or have been, on oestrogen therapy, and seeing if this differs...

Background: Primary hyperparathyroidism (PHPT) is characterized by abnormal regulation of PTH secretion by calcium. The most common clinical presentation of PHPT is asymptomatic (80% cases), followed less likely by the classical symptoms of bones, stones, abdominal moans, and psychic groans. The diagnosis of PHPT is usually first suspected because of the finding of an elevated serum calcium concentration along with a rise in Parathyroid hormone (PTH) level. Serum phosphorus le...

Background: Mild autonomous cortisol secretion (MACS) in patients with adrenal incidentalomas has been associated with elevated cortisol levels during the nocturnal period resulting in a disturbed cortisol rhythm. We hypothesised that administration of nocturnal metyrapone, an 11-beta-hydroxylase inhibitor, previously shown to restore cortisol rhythm in MACS patients, could reduce metabolic complications in this patient group.Met...