Endocrine Abstracts

Hyperparathyroidism is rarely encountered in pregnancy; however, the consequence of untreated disease can be significant for both the mother and fetus (increased risk of miscarriage, IUGR, pre-eclampsia, neonatal hypocalcaemia). NICE guidance (May 2019) on the management of PHPT strongly recommends disease control pre-pregnancy, MDT working and offering surgery if cCa is above 2.85 mmol/l. We report a 31-year-old P4 who was referred to our joint endocrine/obstetric clinic at 1...

G2, P1, IUGR in previous pregnancy. Presented in 34/40 of pregnancy with profound lethargy, muscle weakness and fatigue. Found to have normotensive hypokalaemia − 2.6 mmol/l and mild metabolic alkalosis. No preceding vomiting, diarrhoea or nutritional cause. Pre-natal blood results were not available but reported low K+ in 2009. Required intravenous potassium replacement and symptoms improved dramatically with restoring normokalaemia. Results at diagnosis: K+ ...

Introduction: Severe hyponatraemia is a medical emergency and can be life-threatening. It requires prompt assessment, investigation and treatment which can be a challenge as it presents to multiple departments. We therefore looked to undertake a review of severe hyponatraemia cases in our 1000-bedded acute trust with the aim of determining most appropriate care.Aims and methods: Retrospective notes review of all patients with Na ≤110 mmol/l between...

We present a case of 76-year-old male who attended acute medical unit with 3 week history of confusion, slurred speech and reduced mobility. One month prior to his admission he was diagnosed with severe hypothyroidism with TSH of 100 mU/l and T4 of 1.9 pmol/l and significantly positive anti-peroxidase antibodies (561 IU/ml) and was started on 100 μg of levothyroxine by his GP. During his admission his confusion persisted despite antibiotics for presumed chest i...

An association between the use of proton pump inhibitors (PPIs) and profound hypomagnesaemia has been highlighted in a number of case reports. As the prevalence of this occurrence or cause remain unknown, we undertook a review of patients with significant hypomagnesaemia in our hospital with a particular focus on use of PPIs and management.35 patients (21f; mean age (S.D.): 71.3 (14.6); median: 74 years) with significant hypomagnesaemia (d...

We report a case of severe postradiation encephalitis presenting 6 months following pituitary radiotherapy for pituitary adenoma. Our patient (78 years old female) was diagnosed with non-functioning pituitary ademona compromising the optic chiasm in 1999 at the age of 66 years. She underwent transphenoideal decompression in 2000. Over the next 8 years there was slow re-growth of the pituitary adenoma and by 2008 it was causing optic chiasm compression. At this stage, the patie...

Introduction: Complete androgen insensitivity syndrome (CAIS) is an X-linked genetic disorder characterised by normal female appearance, including external genitalia and the presence of 46XY karyotype. We report a case of CAIS, diagnosed in adulthood, and discuss ethical issues surrounding the disclosure of diagnosis and associated difficulties in further management.Case history: A 33-year-old Nigerian lady was referred to our endocrine service with Prim...

Introduction: Phaeochromocytoma of the urinary bladder is a rare neoplasm and accounts for <1% of all phaeochromocytomas. It is more common in females and the majority of patients present in second and fourth decade. Its common presentation is painless haematuria, headache, palpitation, hypertension and syncope during or immediately after urination.Case history: We present a case of 48-year-old man who presented to Endocrinology with a few months his...

35y male presented with extreme fatigue and symptomatic hypogonadism. He had history of multiple infections since childhood due to combined immunodeficiency syndrome and hypogammaglobulinemia, autoimmune haemolytic anaemia, sensorineural deafness, cytopenias, acute hepatitis with hepatosplenomegaly. Liver biopsy (age 15y) showed chronic hepatitis with necrosis. In 2020 (age 32y) he underwent bone marrow biopsy for progressive pancytopenia demonstrating hypercellularity, but no...

Introduction: The thyroglossal duct is an embryonic structure, lined predominantly by respiratory and squamous epithelium and typically involutes by the 10th week of gestation. If the thyroglossal duct does not involute, it can form cysts due to recurrent inflammation or infection, as it is lined by epithelium that is secretory in nature, with or without the presence of ectopic thyroid tissue. Thyroid tissue is present in the wall of the cyst/duct in 30-60% of cases.<p cla...