Endocrine Abstracts

In recent years, there is increased interest in using maggot debridement therapy (MDT) for ulcer treatment. MDT has shown beneficial effects on ulcers’ rate of healing, need for surgical intervention, and number of antibiotic-free days. In this retrospective study, we looked into the effects of MDT on the length of inpatient stay and need for surgical intervention.Data were collected from 33 randomly selected patients admitted into hospital with pri...

A 38 year old woman was admitted with three day history of right sided chest pain, right upper abdominal pain and vomiting. She has anti-phospholipid syndrome (APS) treated with long term lower molecular weight heparin (Dalteparin) for inferior vena cava thrombosis. On presentation, she was hemodynamically stable with haemoglobin of 154 g/l, CRP 170 mg/l, white cell count 15×109/l, platelet of 90×109/l and sodium of 136 mmol/l. CXR showed consol...

Introduction: Correlation of papillary thyroid cancer and lymphocytic thyroiditis is well documented but the incidence of thyroid malignancies in Graves’ disease especially in the absence of nodular thyroid disease is considered to be uncommon.Method: We conducted a retrospective audit of forty-four patients with established diagnosis of Grave’s thyrotoxicosis treated with total thyroidectomy from 2010-2013 (36 months), in a tertiary care centr...

Melanocortin receptor accessory protein (MRAP) is a single transmembrane domain protein, which has been identified as essential for the cell surface trafficking and signalling of the ACTH receptor (melanocortin 2 receptor (MC2R)). MRAP is essential for the function of MC2R, but regulation of its expression remains unclear. This study aims to identify factors regulating MRAP gene expression and whether these factors would affect the signalling of MC2R.The...

The diagnosis of Pheochromocytomas often poses a great challenge. We report a case of pseudo-pheochromocytoma causing challenges in the clinical diagnosis. A 35-year old gentleman with high BMI, was admitted with worsening headache, visual field defects and accelerated hypertension. MRI pituitary and biochemical profiling revealed a non-functioning pituitary macroadenoma with optic chiasm compression, warranting urgent surgical intervention, vindicating an endocrinology referr...

Non-diabetic euglycaemic ketoacidosis (NDEK) is a rare condition defined as euglycaemia, metabolic acidosis and elevated serum ketones occurring in patients without diabetes mellitus. It is less well known compared to diabetic ketoacidosis (DKA) and euglycaemic diabetic ketoacidosis (EDKA), both happening in patients with diabetes. Here we describe a case of a 35-year old woman, previously fit and well, who presented with unidentified cause of pancreatitis leading to severe me...

Hyponatraemia in pregnancy can be precipitated by various factors, including drugs, fluid excess and oxytocin infusion. It is a common complication of pre-eclampsia toxaemia (PET), although concomitant syndrome of inappropriate ADH secretion (SIADH) in this context is rare. We present a case of SIADH leading to hyponatraemia in a PET patient. A 30 year-old primigravid woman with bipolar disorder and hypertension was admitted with pre-eclampsia at gestational week 28. Her medic...

Case history: A 59 year old Afro-Carribbean male with a 25 year history of cardiac enlargement and hypertension, on multiple anti-hypertensives, presented with increasing breathlessness and several years of markedly reduced exercise tolerance. He was intolerant of spironolactone and eplerenone. His past medical history included hypertersion, obstructive sleep apnoea, Steven-Johnson syndrome secondary to allopurinol, thyrotoxicosis treated with radio-active iodine, monoclonal g...

We present the case and management of a 76 year old man who developed medication-related osteonecrosis of the jaw (MRONJ) as a result of 12 years of bisphosphonate and denosumab treatment for hypercalcaemia in the setting of metastatic parathyroid carcinoma.Within two years of his original parathyroidectomy, he had metastatic recurrence diagnosed with progressive hypercalcaemia; imaging revealed three pulmonary nodules consistent w...

We present the case and management of a 76 year old man who developed medication-related osteonecrosis of the jaw (MRONJ) as a result of 12 years of bisphosphonate and denosumab treatment for hypercalcaemia in the setting of metastatic parathyroid carcinoma.Within two years of his original parathyroidectomy, he had metastatic recurrence diagnosed with progressive hypercalcaemia; imaging revealed three pulmonary nodules consistent w...