Endocrine Abstracts

A 60 year old Caucasian woman was referred to endocrine clinic with persistent hypercalcaemia between 2.8 and 2.9 mmol/l (2.2–2.6), with inappropriately normal PTH at 7 pmol/l (1.48–7.63). Her hypercalcaemia was noted first in 2008. She had no signs or symptoms associated with hypercalcemia. However, she has a strong family history of hypercalcaemia, where her mother required Cinacalcet to control her hypercalcaemia despite two previous parathyroid resections. She ha...

A 26 year old lady presented with a 4/12 history of abdominal distension and lethargy. PMH included learning difficulties and congenital hypotonia and she was in long-term foster care.Diabetes had been diagnosed requiring insulin a few months previously. Examination revealed her to be extremely unwell, with proximal myopathy, purple striae, hirsutism and a firm nodular thyroid gland. She was hypokalaemic (2.8 mmol/l) and alkalotic. Cushing’s assessment(table) revealed ACT...

A 17 year old girl was referred to us from the gynaecology department with history of primary amenorrhea. She was otherwise well and previous medical history included severe acne requiring referral to ENT, plastic surgery and dermatology services at age 13 and hirsutism for which she had privately funded laser treatment. On examination she had acanthosis nigricans and BMI of 22 but was virilised with clitoromegaly, hypertrophied labia majora and hirsuitism. Pelvic ultrasound r...

Background: The Royal College advises 500–800 MBq of Radioiodine(RAI) for toxic multinodular goitres (MNG), and 400–800 MBq RAI for euthyroid MNG. In our institution, a standard low dose of 370 MBq has traditionally been given to all patients with benign thyroid disease. This audit examined whether outcomes are optimal with low dose therapy, and whether a variable dose protocol should be adopted.Patients and Methods: We analysed 49 patients at ...

Introduction: Autoimmune thyroiditis is rarely painful. A tender goitre usually indicates viral thyroiditis. Here, we present a case of a persistent painful goitre due to sclerosing-type Hashimoto’s thyroiditis.Case presentation: Our patient is a 27-year-old mother, with no significant past medical history. She was diagnosed with autoimmune hypothyroidism in October 2005 when 4 months post-partum. At diagnosis her anti-TPO titre was 2041 U/ml...

A 22-year-old pregnant lady presented to the Emergency Department (ED) at 36 weeks of gestation with sudden onset of severe headache and blurring of vision. On examination, she was alert, conscious (GCS: 15/15) and had bitemporal hemianopia, confirmed on formal visual field assessment. MRI brain scan (limited views due to pregnancy) showed a pituitary mass extending into the suprasellar region and reaching the optic chiasm. Serum prolactin (PRL) was elevated at 3876 μ/l (...

A 54-year-old Afro–Carribean woman developed worsening obesity, hypertension, and proximal muscle weakness. Clinical examination revealed cushingoid facies, truncal obesity (BMI 34.8), abdominal striae and a BP of 150/90, Ferriman–Gallway score 12.Investigations:- FBG 10.7 mmol/l, 24 urine cortisols 147 mmol/l, 207 mmol/l (NR 25–280 nmol/24 h), normal short synacthen test (cortisol 471 rising to 1002 nmol/l). Subsequent testing revealed a ...

There is a known correlation between dyslipidaemia and hypogonadism in diabetes. In non-diabetic men, calculated free testosterone correlates better than total testosterone with the elements of the metabolic syndrome. The aim of this study is to investigate if this was also true in diabetic men.Methods: This is a retrospective observational study. We analyzed biochemical parameters from 140 sequential male diabetic patients who attended the diabetic erec...

A 23-year-old man initially presented to his GP with palpable ‘gland in his neck’ for 9 years. He was otherwise well with no medical problems. He has a family history of hypothyroidism. Examination revealed right submandibular gland enlargement and lymph nodes in the anterior cervical region bilaterally. His TPO antibody was negative and the only abnormal result was a raised TSH of 12.7. He was commenced on 50 μg of thyroxine daily. Ultrasound of the neck showed...

Background: Current UK guidelines for the Use of Thyroid Function Tests provide specific recommendations for the use of thyroid function tests in inpatients. Isolated alterations in TSH occur in 15% of inpatients and <2% will have underlying thyroid disorder. Thyroid function should be repeated every 4–6 weeks when changing thyroxine replacement dose or when commencing thionamides.Aim: To identify the indications and frequency of thyroid tests i...