Endocrine Abstracts

We present the case of a 32 year old woman presenting to her GP with right lower leg pain. This pain was worse at night, but responded to simple analgesia. She was initially diagnosed with arthritis but the leg pain worsened and became bilateral. She had no other significant past medical history with no history of fevers, trauma, fractures or dental problems. She had no relevant family, social or medication history.On examination, ...

A 46-year-old lady was referred to endocrinology with thyrotoxicosis. She was diagnosed with Graves’ disease by her GP in October 2016 when presenting with classical symptoms and investigations [TSH<0.01 mIU/L (NR 0.3–4.2), fT4=34.3 pmol/L (NR 9–23), TSHrAb>30 u/mL (NR<0.4), and increased iodine uptake]. She was therefore started on carbimazole 15 mg/day. She returned to her GP in December 2016 reporting resolved symptoms, however, she ...

Background: Ischemic stroke is an unusual but important complication of Graves’ Thyrotoxicosis that is induced by the hypoercoaguable state of thyrotoxicosis.We present a 24-year old female patient admitted with a 3-day history of intermittent slurred speech associated with numbness of the right side of her mouth and face preceded by left sided headache.She had a history of uncontrolled Graves’ disease secon...

Assay interference with various laboratory measurements has been reported in the presence of paraproteins. We report a case of a 57 year old woman, who was referred to endocrine clinic after being found to have elevated total vitamin D levels of 369 and 336 nmol/l (normal 50–100 nmol/l). She was not known to be on any Vitamin D supplements that could account for such high levels. Around the time of referral, she was also diagnosed with IgM paraproteinaemia. Therefore, pos...

A 41 year-old male was referred urgently from secondary care with high suspicion of Cushing’s syndrome. His past medical history included psychosis and bipolar disorder, previous low impact foot fractures, rib fractures on coughing and spinal wedge fractures on X-ray, all within the last 5 years. He was taking quetiapine 300 mg modified-release and amitriptyline 10 mg daily, and tramadol 50 mg as needed. The patient reported decreasing mobility with increasing back pain, ...

Female with primary hypogonadism have inadequate function of the ovaries, with impaired production of germ cells (eggs) and sex hormones (oestrogen and progesterone). We recently came across a 22-year old female with short stature in childhood and adulthood she received growth hormone treatment (due to arrested puberty) between 3-5 years of age and further treatment at age of 10 years. She had history of IUGR, primary amenorrhoea, sensorineural deafness, congenitally missing t...

A 59-year-old woman with 46XY complete androgen insensitivity syndrome was referred back to our service. She also has history of hypertension and migraines. She was gonadectomised at the age of 15 years and treated with Ethinylestradiol. She married and was able to have enjoyable sex without the need for vaginoplasty or dilators. However, at 54 years she was firmly advised to stop Ethinylestradiol due to satisfactory bone density and “risks of HRT outweighing benefits&#14...

Case history: We report an interesting case of a rare cause of hypopituitarism where our patient presented to the hospital with acute onset headache, vomiting, and feeling generally unwell. Investigations/Results: On routine bloods, he was found to have hyponatremia. On further workup of hyponatremia, he had low morning cortisol which was confirmed as secondary adrenal insufficiency on dynamic function testing. He was also deficient in gonadotrophins alo...

Introduction: Historically there are many examples of doctors using language which does not aid joint decision making with patients. At medical school we are taught to find out the presenting complaint rather than the reason for attendance. We write about non-compliance with treatment in the medical records rather than barriers to adherence. Similarly we use language in the Diabetes clinic which can disempower the children and families who attend our clinics.<p class="abst...

Sarcoidosis is a multiorgan disease often affecting the lungs and lymphatic system. Neurological involvement occurs in sarcoidosis as granulomas infiltrate the nervous system. Here, we present a case of neurosarcoidosis diagnosed following non-specific neurological symptoms and delayed hypercalcaemia. A 32-year-old female presents with headaches, vomiting and acute confusion. During admission she developed unresponsive episodes. She has a background of type 1 diabetes and hypo...