Endocrine Abstracts

Introduction: Free thyroxine (FT4) assays are available on different commercial platforms where manufacturers provide different reference ranges. The lower limit of normal varies considerably between 8 and 13.9 pmol/l depending on the FT4 assay being used. There is concern about the validity of these reference ranges in paediatric populations, especially for the Roche FT4 assay; here there is a tendency for FT4 results to be below age-related lower limits of 13.9 or 13.6 pmol/...

Introduction: Adrenal crisis is a life-threatening condition and an absolute medical emergency, requiring prompt diagnosis and treatment to prevent grave morbidity and mortality. We describe a case that posed significant diagnostic dilemma due to incongruity of history and clinical findings.Case Report: A 9-year-old girl presented acutely with loss of consciousness, GCS of 5/15. This was preceded by a 3-day history of abdominal pain, vomiting and diarrho...

Introduction: Commonest causes of pancreatitis are alcohol and gallstones but less common causes like hypertriglyceridemia should also be considered as management may differ.Case history: 47 years old gentleman with history of pancreatitis and hyperlipidaemia type1 taking atorvastatin and bezafibrate, admitted with severe abdominal pain and vomiting. He was non-smoker and non-drinker. No history of cholelithiasis or medications causing pancreatitis. He w...

Background: Metastatic disease is common in bone, with the majority occurring in the spine, pelvis, and long bones such as the femur and humerus. Acrometastasis, a term used to describe malignant spread distal to the elbow and knee, is a pattern less commonly seen. Its rarity often leads to delayed diagnosis; the condition may be confused with more common conditions such as inflammatory arthritis and Charcot neuroarthropathy, the latter especially in particular in patients wit...

Aim: To audit clinical outcomes and adherence to prescription recommendations in a diabetes renal clinic.Method: Baseline data was compared to the final clinic visit within a 12 month period, using information from clinic letters and electronic records of patients attending our hospital diabetes renal clinic in 2016 (1st January – 31st December). Patients with at least 1 follow-up within a 12 month period were included.Results...

Introduction: Hyponatraemia is the commonest inpatient electrolyte abnormality and its severity correlates with inpatient mortality, length of stay and use of hospital resources. Frequently, hyponatraemia is not sufficiently acknowledged in the acute medical setting. The aim of this audit was to evaluate the investigation and management of hyponatraemia in a district general hospital.Methods: Seventy-seven hyponatraemic patients (Na<...

Background: Endocrine emergencies such as hyponatraemia and hypercalcaemia commonly present during unselected medical on-call. However, in our hospital a questionnaire survey of trainees revealed lack of confidence and preparedness in managing endocrine emergencies. 18 trainees responded (12 Foundation Year 1 (FY1), 1 Foundation Year 2 (FY2), 5 Core Medical trainees (CT1) reporting lack of confidence and preparedness in managing endocrine emergencies. 76.92% of FY1 doctors fel...

Background: Continuous subcutaneous insulin infusion (CSII) therapy is increasingly used for managing children with type 1 diabetes mellitus. Devices vary in design by manufacturer; however in general terms insulin is administered from the pump via a subcutaneous plastic catheter or needle. If the pump or the circuit malfunction and interrupt the insulin infusion, it can put the patient at risk of hyperglycaemia.Case: A 5-year-old boy with type 1 diabete...

Introduction: Testicular adrenal rest tumours (TARTs) are a complication of congenital adrenal hyperplasia (CAH), stimulated by hyper-secretion of adrenocorticotropic hormone (ACTH). They are the main reason for fertility problems in men with CAH owing to compression of the seminiferous tubules, obstructive azoospermia and potentially permanent testicular damage. These lesions are benign and, in most patients present bilaterally. TARTs are treatable, but they can be misdiagnos...

Introduction: Injectable somatostatin analogues (SRLs) are the standard medical management of acromegaly. Injection site adverse reactions reported for parenteral SRLs were examined in the literature and in the FDA Adverse Events Reporting System (AERS), and compared to the respective drug labels.Methods: PubMed was searched using criteria: period 1995–2013, drugs – octreotide (Sandostatin®), lanreotide (Somatuline®</s...