Endocrine Abstracts

A 52 year-old female, newly diagnosed with Type 2 Diabetes during pre-operative assessment for cholecystectomy, was referred to Diabetes clinic. An initial trial of metformin was discontinued in view of intolerable gastrointestinal side effects and the patient was started on low dose gliclazide. The patient’s main concern was her struggle to lose weight despite lifestyle measures, a seemingly common issue faced by patients with diabetes on sulphonylureas. On further exami...

Case history: A 59 year old woman presented to hospital with severe abdominal pain, diarrhoea and vomiting. Her past medical history included end stage renal failure of unknown cause, renal transplant with antithymocyte globulin (ATG) induction ten years prior, treated pulmonary tuberculosis, hypertension and new onset diabetes after transplant (NODAT).Investigations: A CT scan of the abdomen demonstrated an 85 x 74 x 96mm heterogenous mass arising from ...

Context: NICE and BTA agrees that combination L T4 and LT3 can be used in patients with symptoms persisting after adequate use of LT4.Methods: We retrospectively audited the patients coming to the endocrine clinics of ESHT whether they followed the local agreed protocol of LT3 usage. We checked if they had:1. Initiation of LT4 by an endocrine specialist.2. If other causes of tiredness were ruled out.<p cl...

27 years old lady with recurrent Graves’ thyrotoxicosis for 5 years delivered her baby uneventfully and her thyrotoxicosis worsened 2 months after pregnancy when her FT4 bounced back up to 38 pmol/l (12–22) so her propylthiouracil (PTU) was increased from 200 to 400 mg. Despite of continuing high dose of PTU for few months she remained thyrotoxic and became neutropenic [Neutrophil 0.67×109 (2–7)], decision was made to proceed with thyroidectomy b...

Case History: A 46 year old lady presented with deranged thyroid function (TSH 0.05, T4 19.7). She reported palpitations, mild eye irritation, sweats and weight loss. Examination revealed a resting tremor and regular pulse (72 bpm). A small goitre with bruit was present, but no evidence of thyroid eye disease. Block-and-replace regime of carbimazole and levothyroxine was commenced for Graves’ disease. Thyroid peroxidase antibodies were <1. After one year of euthyroidi...

History: 80 years old male was admitted in June 2016 with a head injury. His CT head showed small subarachnoid haemorrhage and shallow frontal subdural hematoma. He was managed conservatively as per advice from neurosurgical department and was discharged on 4th July. He was readmitted on 9th July suffering from confusion and found to have sodium of 114 which was 141 a week ago.Investigation: Investigations carried out to find the ca...

Background: Hyponatraemia is a frequent finding in medical inpatients, where a comprehensive evaluation is warranted to establish the underlying mechanism and guide further management. Whilst the role of confounding medications, syndrome of inappropriate anti-diuretic hormone (SIADH), adrenal insufficiency and polydipsia is well-established as causative factors in the development of hyponatremia, the link between hypothyroidism and hyponatremia is controversial in the medical ...

Background: The psychopathology of children and young people with Turner Syndrome (45,X; TS) has been well-documented. But these studies have never assessed neurodevelopmental disorders (NDD; autistic/attention-hyperactivity) alongside emotional and conduct disorders. The last extensive study of mental health assessed a narrow range of psychopathologies and excluded under 16s. This study aims to comprehensively examine mental health, NDD and social skills in TS from childhood ...

Background: Turner Syndrome (TS) is a sex chromosome aneuploidy (45,X) associated with social skill difficulties. The 2016 Cincinnati clinical care guidelines recommend that the Program for the Education and Enrichment of Relational Skills (PEERS) social skills intervention is piloted. PEERS has previously been used in face to face interventions with male adolescents with autism spectrum conditions. This pilot project will be the first to examine the feasibility and acceptabil...

Introduction: The Oxford multidisciplinary thyroid eye disease (TED) clinic comprising an oculoplastic surgeon, rheumatologist and endocrinologist with access to orthoptics, neuroradiology and radiotherapy was established in 2013. The aim was to facilitate rapid referral and treatment in a specialist centre in keeping with Amsterdam Declaration. Early use of steroid sparing agents (SSA) and recently rituximab forms part of the treatment regimen.Methods: ...