Endocrine Abstracts

Background: Immunotherapy has become one of the standard interventions to treat various malignancies and auto-immune conditions with favourable responses to the treatment. However, the immune related adverse events of these medications are diverse which may include a variety of endocrinopathies, like Hypo cortisol, Hypophysitis, hypo and hyperthyroid states.Case report: A 62 year old female with a background of Metastati...

We present here a case of 70 year old female, seen in endocrine clinic for Hypothalamic-Pituitary-Adrenal (HPA) axis suppression after prolonged glucocorticoid use. History revealed that she had prolonged use of prednisolone for her asthma in the past. In 2011, Prednisolone was stopped but she had to be started on Hydrocortisone replacement due to HPA axis suppression. She was taking Hydrocortisone 20 mg BD. Trials to wean her off Hydrocortisone failed due to ongoing tiredness...

Introduction: Acromegaly is a rare chronic disorder caused by growth hormone hypersecretion due to GH-producing pituitary adenoma. Surgery is the first-line treatment modality. However, patients with severe cardiac involvement are high-risk candidates for pituitary surgery. These patients may benefit from rapid preoperative biochemical control of acromegaly. There is emerging evidence of efficacy of pegvisomant, a GH-receptor antagonist, (either alone or in combination with so...

A 49-year old woman presented with four months history of drowsiness and weakness. She had twelve years history of intermittent menorrhagia, and was treated with iron and folic acid tablets, with partial relief. Clinically she was dehydrated, drowsy, pale and had pedal edema. Pelvic examination revealed a uterine mass 16 centimeter in diameter. Investigations- hemoglobin 9.0 gm/dl, peripheral smear microcytic, hypochromic anemia,serum albumin- 2.8 g/dl (3.6–4.7 g/dl), ser...

Synthetic levothyroxine (L-Thyroxine) is the treatment of choice for hypothyroidism. It is safe, effective and generally well tolerated. Some patients, however, cannot tolerate L-Thyroxine. There is still some controversy about the effectiveness of combination T4 & T3 therapy. We describe 3 patients who were successfully treated with Armour thyroid (pork extract of T4 & T3) after being intolerant to L-Thyroxine.A 35 yr old lady initially presente...

In the current era of multi-modal imaging being performed for various pathologies, incidental non-functioning pituitary microadenomas (NFPAs) are being increasingly identified. The available literature and guidance is limited on the long-term surveillance and monitoring and hence there is a wide variation in clinical practice across the UK. We conducted a retrospective study in our institution to compare the outcome in our cohort to the current literature.<p class="abstext...

Pathogenic variants in the SDHx genes are responsible for ~20% of familial Phaeochromocytoma/Paraganglioma (PPGL) tumours. Metastatic disease is lower in SDHD in comparison to SDHA, B and C mutations. Although the genotype-phenotype relationship is not well established it is considered that truncating SDHD pathogenic variants have a higher risk of causing disease in comparison to missense variants. We present two cases of metastatic paraganglioma in patients with heterozygous ...

Aim: To determine if inpatient hypoglycemia management in our trust is compliant with NICE guidelines and understand the conundrums in documentation and treatment of the hypoglycemic episodes.Method: Retrospective audit on all patients admitted in Huddersfield Royal Infirmary who had hypoglycemic episode(s) in March 2021 which were picked up by wireless-enabled central capillary blood glucose monitoring system (cobas)1.R...

68 years old female initially referred to endocrine clinic in November 2016 for assessment of fluctuating thyroid function. She had a history of long standing primary hypothyroidism, stable on treatment with 100 mcg Levothyroxine. In last one year, Levothyroxine was tapered and stopped due to persistent suppression of TSH and high normal Free T4. Last tests showed TSH of <0.01mIU/l and Free T4 of 27.1 pmol/l. She had ongoing complaints of feeling increasingly tired and gen...

Introduction: Prevalence of obesity is increasing worldwide. As a consequence the number of people undergoing bariatric surgery is also on the rise. Hypoglycaemia is increasingly seen in patients who have undergone gastric bypass surgery and we have successfully managed most of them. Here we describe our experience in dealing with one of the patients with disabling hypoglycaemia.Case-report: A 35-year-old woman with BMI of 41.87 kg/m2 had Roux...