Endocrine Abstracts

There are currently no robust methods for screening patients at risk of developing osteoporosis. Women tend to be more susceptible to low bone mineral density (BMD), whether its genetic, disease related, or menopausal and osteoporosis can also affect men. Access to dual energy x-ray absorption units (DEXA), is scarce and waiting lists are long. This has been exacerbated by the pandemic and the growing referral lists for radiology services. The burden of the disease processes i...

GH replacement (GHR) has resulted in a significant improvement in quality of life for many adults with GH deficiency. Many of these patients are previously irradiated survivors of malignancy, and as such are at high risk of recurrent (RN) or secondary neoplasms (SN). There is a particularly strong association between CNS irradiation and subsequent development of meningiomas, which are known to express GH receptors. There is uncertainty as to whether GHR increases the risk of d...

Background: The correlation linking Myasthenia Gravis (MG) and pituitary adenomas is exceedingly uncommon. Our thorough investigation of medical literature uncovered merely eight documented cases showcasing this association. Notably, five of these cases specifically involved adenomas that secreted prolactin¹. Two instances implicated a non-functional pituitary adenoma in this rare association². Solely one case was identified involving a growth hormone (GH)-secreting ...

Case history: A 32 year old male diagnosed with McCune-Albright syndrome aged 18, presented with a painful left knee and difficulty in walking, limiting his usual activities. He was diagnosed with Acromegaly (IGF-1 451 ng/ml, mean GH 2.71 ug/L) aged 26 years and had multiple sites of fibrous dysplasia, causing bone pain. On examination he had tall stature and features of acromegaly with normal visual fields and palpable masses behind his left knee and upper thigh.<p class=...

Case history: A 54 year-old gentleman was transferred as an inpatient from another centre for investigation and management of refractory hypoglycaemia following a revision gastric bypass. He was requiring a continuous infusion of 20% dextrose on transfer to maintain normoglycaemia. He had a complex bariatric surgical history dating back 7 years. His initial procedure had been a sleeve gastrectomy that was subsequently converted to a gastric bypass which had then been reversed ...

Case History: A 68-year-old gentleman was admitted to the hospital following a history of weight loss, lethargy, tiredness for about 6 months. His past history includes hiatus hernia, esophagitis and kidney stones. He reported taking over the counter vitamin D (60,000 IU daily) for more than 2 years. He was not on any other regular medications.Investigations: His initial investigations showed acute kidney injury with severe PTH independent hypercalcaemia...

Background: Hyponatraemia is known to be associated with significantly increased mortality in hospitalised patients. We identified the number of cases of hyponatraemia referred for an endocrine opinion in our hospital, examined the causes present, and assessed how the speed of referral to endocrinology could affect the management. Methods: Inpatient referrals were audited over a 6-month period from 1st October 2021 to 30th April 2022. Data regarding the ...

Gestational Diabetes Mellitus (GDM) is associated with adverse outcomes, including large-for-gestational age (LGA) babies who are are at greater risk of developing cardiovascular and metabolic diseases in adulthood. The mechanisms responsible for LGA are unclear but it is associated with altered placental development/function. Recent data also shows a link between temporal changes in maternal glucose and LGA; women with GDM that deliver appropriate for gestational age (AGA) in...

Background: Normal maternal thyroid function is essential for optimal fetal neurological development. However, targeted screening for thyroid dysfunction in the first trimester of pregnancy, together with the criteria that should be applied, remains controversial.Aim: To determine the efficacy of targeted screening for discovering new cases of thyroid dysfunction in pregnancy.Method: All women who delivered their babies at Imperial...

Case history: A 40-year-old, primaparous woman was referred at 24 weeks’ gestation to Obstetric Medicine for review of abnormal thyroid function tests (TFTs).Investigations: One year prior to pregnancy, TFTs included a thyroid stimulating hormone (TSH) level of 0.95 mU/l (local non-pregnant reference range 0.3–4.2 mU/l) and a free thyroxine level (fT4) of 7.3 mU/l (local non-pregnant reference range 9.0–23.0 mU/l). At 18 weeks’ gestat...