Endocrine Abstracts

Background: Insulin resistance is the reduced responsiveness of the body to the glucose-lowering activity of insulin. It is usually associated with obesity, but in a minority of patients, this is not the case. Single gene mutations can often be found in such patients, some of which affect the insulin receptor (INSR). There is a spectrum of genetic insulin receptoropathies. These can be considered as two groups. One group comprises rare, severe, autosomal recessive disorders: D...

Introduction Adrenal myelolipomas are rare small benign tumours composed of mature fat and hemopoietic tissues, which can be associated with congenital adrenal hyperplasia (CAH). We report a rare case of massive bilateral adrenal myelolipomas.Case report A 48 year old gentleman with CAH diagnosed during childhood presented at a routine endocrine appointment. He had not regularly attended his appointments or taken his steroids f...

Introduction Adrenal myelolipomas are rare small benign tumours composed of mature fat and hemopoietic tissues, which can be associated with congenital adrenal hyperplasia (CAH). We report a rare case of massive bilateral adrenal myelolipomas.Case report A 48 year old gentleman with CAH diagnosed during childhood presented at a routine endocrine appointment. He had not regularly attended his appointments or taken his steroids f...

Background: Amiodarone induced thyrotoxicosis (AIT) is a potentially catastrophic situation for patients with cardiac disease who are at risk of life-threatening complications. We describe the protracted and challenging journey of a patient with Laminopathy and a significant cardiac history who developed AIT.Clinical Case: A 53-year-old man was referred with thyrotoxicosis (TSH <0.01mU/l, free T4 61 pmol/l, free T3 8.0 pmol/l) detected following comm...

Background: Pancreatic Neuroendocrine Tumours (pNETs) can be associated with cancer susceptibility syndromes such as Multiple Endocrine Neoplasia type 1 (MEN1). MEN1 increases a person’s chance of developing pNETs, which are the main cause of mortality in this cohort. A diagnosis of pNETs, therefore, provides the opportunity for detection of associated MEN1 and subsequent identification of asymptomatic relatives who would then undergo relevant clinical, biochemical and ra...

Intro: Diabetic Ketoacidosis (DKA) is a medical emergency characterised by hyperglycemia, ketosis and acidosis. If left untreated it can lead to cerebral oedema, acute kidney injury, Adult Respiratory Distress Syndrome andeven death. Euglycaemic DKA (EuDKA) without hyperglycaemia is rare but increasing cases of EuDKAbeing reported in patients taking SGLT2 inhibitors.Case report: A 53 year old, Type 2 Diabetic was admitted for an elective cholecystecomy. ...

A 65 yo gentleman was referred to the endocrinology department with thyrotoxicosis. He had a history of IHD and recurrent VT necessitating amiodarone for 8 years. Routine TFTs had shown TSH undetectable, fT4 34.1, fT3 8.7. There were no symptoms or signs of thyrotoxicosis or cardiovascular compromise. He had been treated with carbimazole by his GP for the previous 3 weeks, this was discontinued at the initial evaluation due to recurrent vomiting. TPO anti...

Introduction: Adrenal incidentaloma is defined as a clinically inapparent adrenal mass that is incidentally detected after imaging studies conducted for reasons other than the evaluation of the adrenal glands. Existing guidance suggests that excess catecholamine and cortisol secretion should be ruled out all cases and excess aldosterone secretion should be ruled out hypertensive patients. Certain features on CT scanning such as a Hounsfield value of over 10 are useful in diffe...

We describe below a 72-year-old woman who presented clinically with short metacarpals and metatarsals and the following blood biochemistry: corrected calcium of 2.16 mmol/l (normal: 2.05–2.60), phosphate 0.61 mmol/l (normal: 0.8–1.45) and alkaline phosphatase of 108 U/l (normal: 35–104). She was 153 cm tall and weighed 109 kg with a round face. She had a history of Monoclonal Gammopathy of unknown significance, vitamin B12 deficiency and was admitted 10 years ag...

One possible route for treating type 1 diabetes is through an induced augmentation of beta cell mass. Some success has been achieved in recent years using islet grafts into the liver but at present the main limitation to the wider application of this technique is the limited supply of islets from human organ donors. To overcome this problem, alternative sources of β-cells need to be found. One approach is via transdifferentiation, or the conversion of one cell type...