Endocrine Abstracts

Background: Infertility affects 1 in 6 couples causing devastating psychological impact. In vitro fertilisation (IVF) treatment can aid couples to conceive, but personalisation of treatment is needed to optimise patient outcomes. Machine learning can aid in the analysis of large complex datasets such as those encountered during IVF treatment. One example is in determining the optimal follicle size on the day of trigger to maximise the number of oocytes collected. Both follicle...

Case: We report a 79-year-old female who was referred to our Endocrine Bone Unit with osteoporosis, which was initially treated with Alendronate (but poorly tolerated due to dyspepsia) followed by annual Zoledronate infusions. Her bone history was significant for a proximal humeral fragility fracture 30-years previously. She was an ex-smoker, had limited dietary calcium intake, and had a brother with osteoporosis. DEXA demonstrated T scores at lumbar spine -1.8, total hip -2.0...

A 35 year old lady presented with a one week history of back pain, myalgia, fatigue, epigastric pain, and persistent vomiting. She reported a four week history of reduced appetite and 4 kg weight loss. She had recently recovered from an uncomplicated COVID-19 infection. Past medical history included a previous eating disorder (anorexia and bulimia), and subsequent chronic gastritis. Drug history included Omeprazole 20 mg daily, Laxido 2 sachets daily and antacids (Rennies 4-8 ...

A 27-year old Caucasian woman was referred to the Endocrine Bone Clinic after investigations for general malaise revealed hypercalaemia and elevated parathyroid hormone levels. She had no history of constipation, abdominal pain, bone pain, or other related symptoms. She had no history of renal stones or fractures and no change in weight. Her past medical history included asthma and she took a salbutamol inhaler as required. She had no family history of endocrine pathology. Gen...

A 33 year-old man was referred to the endocrine bone clinic following presentation with a 4 mm kidney stone and hypercalcaemia. Apart from mild fatigue, he had no other hypercalcaemic or concerning symptoms. He was not on any medications or supplements. He had a positive family history for kidney stones and reported that his grandmother had been noted to have hypercalcaemia in the past. There was significant consanguinity in his family. Examination was entirely normal while bl...

A 60-year-old Caucasian lady was referred to the metabolic bone clinic for assessment of osteoporosis. Her risk factors for osteoporosis included gender, postmenopausal status, childhood immobility due to illness, previous severe vitamin D deficiency, COPD, as well as an extensive smoking and alcohol history. She had multiple previous fragility fractures involving her ribs and both radii. A DEXA scan revealed lumbar osteoporosis (T -4.0) and femoral osteopenia (T -2.0). Thorac...

Introduction: Graves’ disease is the commonest cause of hyperthyroidism accounting for 80% of all cases. The first line treatment for Graves’ disease in the UK is medical therapy, most frequently using a ‘dose-titration’ regimen. Currently, there is a lack of guidance to aid clinicians in carrying out optimal dose-titration of carbimazole, resulting in a risk of under- or over-treatment. Thus, we aimed to develop a carbimazole dosing-algorithm for the medic...

A 61 year-old woman presented with a two year history of facial hirsutism and frontal balding. She did not report voice change or acne. Menarche was at age 14 with regular menses until a hysterectomy (with ovarian preservation) for menorrhagia aged 29. She had a past medical history of T2DM and gastric bypass surgery. She was not on androgenic medication. Examination revealed clinical hyperandrogenism with androgenic alopecia and hirsutism (FG score 20) but no cliteromegaly. T...

Introduction: Diaphoresis, or excessive sweating, is well recognised as a presenting complaint for endocrine disorders such as hyperthyroidism, acromegaly, and phaeochromocytoma. However, diaphoresis is an unusual presenting complaint for Cushing’s syndrome.Case: We present the case of a 35-year-old lady who first presented to health services for symptoms of excessive sweating, and feeling hot most of the time. Whilst initial investigations such as ...

Introduction: Graves’ disease is an autoimmune disorder which may lead to thyroid overactivity and eye disease. Oestrogen and progesterone are thought to be immunomodulatory and have been postulated to play an important role in the difference in prevalence of autoimmune disorders between men and women. Autoimmune disorders, including autoimmune thyroid disease, are often quiescent during pregnancy with an increased prevalence postpartum. The increase in immune mediated th...