Endocrine Abstracts

Case: A 46-years-old anaesthetist presented with 2 weeks history of general malaise, sore throat, and fever. Symptoms started while on holiday. A diagnosis of subacute thyroiditis was made overseas based on presentation and suppressed TSH level. He was started on betamethasone 4mg and ibuprofen for 2 weeks with rapid symptomatic improvement. He felt well enough to travel back to UK. He then presented to our hospital with recurrent symptoms as above.Inves...

Insulinomas are rare neuroendocrine tumours that classically present with a combination of symptomatic hypoglycaemia, low serum glucose values and resolution of symptoms post glucose ingestion.We describe a 65-year-old lady who repeatedly presented over several years with recurrent infections, predominantly of the urinary tract, nausea and diarrhoea, necessitating frequent hospital admissions. Despite extensive investigations, no clear cause for her symp...

Background: The diagnosis of isolated GH deficiency (IGHD) is based on multiple factors: clinical, radiological and biochemical along with suboptimal peak GH levels demonstrated on dynamic testing. Recent guidance from the National Institute of Clinical Excellence (NICE; UK; 2010) advises that two GH stimulation tests must demonstrate a subnormal GH peak <6.7 μg/l (20 mU/l) to confirm the diagnosis of IGHD. In our centre, three different GH provocation tests are used:...

Recombinant growth hormone (GH) administration uses several different injection devices. Despite offering free patient choice at GH therapy start, ~20% of our patients subsequently change GH device.Objective: To investigate reasons for GH device change, and evaluate the effect on adherence, height velocity standard deviation (HVSDS), and insulin-like growth factor-1 (IGF1).Method: Retrospective study of extracted growth data and la...

We report two patients with thyroid nodules where thyroid cancer has unexpectedly been found. The first patient presented at the age of 58 years with a lump in her neck. She was clinically and biochemically euthyroid. Ultrasound revealed a solitary left hypoechoic nodule (23×17 mm), with no other suspicious sonographic features. She had two FNA’s over a two year period which were reported as showing no malignant cells (THY2). Three annual ultrasounds showed no change...

We report a case of a 27 yr female patient who initially presented with jaundice at 38 weeks gestation, with biochemical transaminitis. She had a caesarean section which was complicated postoperatively by hypotension due to haemorrhage requiring 20 units of blood/blood-products. A specialist liver unit felt the jaundice was secondary to fatty liver of pregnancy. She had difficulty breastfeeding and 18 months post partum she still had secondary amenorrhea so was commenced onto ...

Introduction: Genomic testing is expected to become a part of mainstream testing in the not-too-distant future, with clinicians ordering genetics tests in the same way routine endocrine tests are requested today. Knowledge on how and what test to request needs to be gathered by a wide range of physicians. To support this, the Genomics Education Programme of NHS England is developing a resource for all endocrinologists to use in clinic as part it’s Genomic...

Introduction: Carcinoid crisis is a life threatening endocrine emergency. It remains unclear whether there is an optimal dose of prophylactic somatostatin analogue (SSA) therapy in the peri-operative periodCase Study: A 62 year old lady with a new diagnosis of metastatic carcinoid disease was electively admitted for a right hemicolectomy for a well differentiated neuroendocrine tumour in the terminal ileum. A multi-disciplinary decision was made to offer...

A 68 year old gentleman referred to endocrinology clinic with a few years history of erectile dysfunction (ED), which manifested as reduced libido and partial erections. Investigations revealed primary hypogonadism with a low morning serum Testosterone of 4.8 (Ref: 7.9-31 nmol/l), raised FSH at 47 (Ref:1.5-12.4 iu/l) LH at 36.8 (Ref: 1.7-8.6iu/l) and normal thyroid function tests (TFTs). The patient declined testosterone replacement therapy following a discussion of pros and c...

Case history: A 32 year old female was admitted for an elective gynaecological procedure LLETZ (large loop excision of the transformation zone) under general anaesthesia as per patient”s request. An uncomplicated LLETZ procedure was performed. Post operatively, patient was found to be tachycardiac and had severe palpitations with nausea. She then reported that she had recently lost a significant amount of weight, had been suffering with anxiety, palpitations, and tremors ...