Endocrine Abstracts

Case summary: A 55 year-old lady was referred by ophthalmology following diagnosis of bilateral central serous retinopathy, an accumulation of sub-retinal fluid at the fundus associated with Cushing’s syndrome. She also had proximal myopathy, bruising, centripetal weight gain and hypertension. Cushing’s was confirmed by 1 mg overnight DST (cortisol 581 nmol/L) and 48 hr-LDDST (407 nmol/L). 24 hr UFC was raised at 2666 nmol/L (12...

Case summary: A 55 year-old lady was referred by ophthalmology following diagnosis of bilateral central serous retinopathy, an accumulation of sub-retinal fluid at the fundus associated with Cushing’s syndrome. She also had proximal myopathy, bruising, centripetal weight gain and hypertension. Cushing’s was confirmed by 1 mg overnight DST (cortisol 581 nmol/L) and 48 hr-LDDST (407 nmol/L). 24 hr UFC was raised at 2666 nmol/L (12...

Case history: A 20-year-old man was referred to the metabolic bone clinic following a left sided neck of femur fracture (sustained after a simple fall whilst roller skating). He was otherwise well with no past medical history; systemic enquiry was unremarkable. A DEXA scan revealed osteoporosis (Z scores: total hip −2.97; lumbar spine −3.1), and bone turnover markers were significantly raised. Unexpectedly, the patient was found to have an elevated serum t...

Background: Recombinant human TSH (rhTSH) promotes 131I uptake in selected populations. Lithium increases RAI retention by reducing intra-thyroidal release. In this report, combination of rhTSH and lithium overcame low RAIU in Graves’ disease.Objective: We aim to present the case of a Graves’ disease given combination of rhTSH and lithium to overcome amiodarone-induced low 131I uptake.Methods and res...

Insulin resistance is associated with obesity, metabolic syndrome and hypertension. These risk factors for type 2 diabetes and cardiovascular disease may be programmed by the early diet. Previous studies have shown poor insulin sensitivity in obese relative to lean sheep. Here, we considered whether insulin sensitivity in pre- and postnatally nutritionally challenged sheep offspring was due to changes at the pancreatic level. Thirty-six twin-bearing ewes were randomly allocate...

Primary hyperparathyroidism in pregnancy is reported as being rare rare. It can be associated with significant complications. Maternal complications include symptomatic hypercalcaemia, renal calculi, hyperemesis, muscle weakness, and pre-eclampsia. Fetal complications include IUGR, low birth weight, preterm delivery, intrauterine death, neonatal tetany and fits.Patient 1 presented with asthma and was found to have primary hyperparathyroidism, corrected c...

A 44 year old woman presented with leg swelling. Past history included hypothyroidism and ulcerative colitis treated with eltroxin (100 mg/day) and azathioprine (100 mg/day) respectively. Clinical examination revealed pitting oedema to knees and a ’puffy face’. Free T4 was 5.8 pmol/l (12–22 pmol/l), TSH 84.61 mU/l (0.27–4.20), serum albumin 24 g/l (40–49 g/l). She reported good compliance with L-thyroxine and no recent gastrointestinal symptoms. L-thyr...

Background: Clinically relevant pituitary adenomas (Pit PA) affect approximately 1:1200 of the general population, and may manifest with hormone hypersecretion, hypopituitarism and compression of the visual pathways. Primary aldosteronism (Adr PA) is now recognised to account for 5–14% of all cases of hypertension and is associated with excess morbidity when compared with primary hypertension. Here, we report a patient who was noted to have a history suggestive of Adr PA ...

Background: Accurate assessment of GH & IGF1 status in acromegaly is crucial for informing management to minimise excess morbidity/mortality. Expert panels have differed with respect to recommended testing modalities and thresholds – the most recent being the Endocrine Society 2014 guidelines. We evaluated their simplified algorithm, which minimises the need for day-case testing, against other more resource-intensive measures.Methods: A retrospe...

Mrs. P.A., a 75 year old lady, presented to Accident and Emergency with a severe persistent headache of 3 days duration. She was disorientated and drowsy. She has a history of type 2 diabetes, hypertension, hypercholesterolaemia, depression and hypothyroidism. She was a smoker of 20 a day and consumed no alcohol. Her Glasgow Coma Scale was 13/15, her examination was normal. An initial CT head showed a pituitary tumour with haemorrhage. Tests showed an FSH of 14.1 IU/L, LH 2.9 ...