Endocrine Abstracts

A 68 year old gentleman referred to endocrinology clinic with a few years history of erectile dysfunction (ED), which manifested as reduced libido and partial erections. Investigations revealed primary hypogonadism with a low morning serum Testosterone of 4.8 (Ref: 7.9-31 nmol/l), raised FSH at 47 (Ref:1.5-12.4 iu/l) LH at 36.8 (Ref: 1.7-8.6iu/l) and normal thyroid function tests (TFTs). The patient declined testosterone replacement therapy following a discussion of pros and c...

Introduction: We present two pregnant women who were referred to obstetric endocrinology service with polyuria and polydipsia. They were investigated and treated for diabetes insipidus (DI). In both cases, the underlying pathophysiology was ADH insufficiency secondary to autoimmune lymphocytic hypophysitis. There are currently no consensus guidelines on the diagnosis of DI during pregnancy. These cases highlight best practice and endorse MDT management of chronic hypopituitari...

Introduction: Hypothyroidism can present in a variety of ways, from unexpected abnormal blood results in seemingly asymptomatic patients to those with a multitude of debilitating symptoms. Levothyroxine dose titration is a challenge often faced by physicians. We identified 8 difficult cases which following MDT discussion underwent the Thyroxine Absorption Test (TAT) to gain further clarification (Walker et al. 2013).Aim: To identify if the issue...

The prevalence of adrenal incidentaloma on abdominal Computed Tomography (CT) is around 4.4%. This prevalence is increased in obese, diabetic, hypertensive patients, and could be as high as 10% in older patients. Unilateral adrenal masses larger than 4 cm should be considered for surgical removal to avoid missing adrenal carcinoma, particularly in younger patients.This is the case of a 67 year old gentleman with Type 2 diabetes mellitus, known to have hy...

We report a case of a male patient aged 45 years who presented with a history of intermittent back discomfort over a year, but more persistent over the previous 2–3 months. His general practitioner (GP) referred him for an ultrasound of the spine for a possible encapsulated lipoma but the findings were unremarkable. He was then referred to a consultant gastroenterologist for further assessment. He had normal endoscopic examinations, however the MRI had shown a right adren...

This is a case of a 48-year-old lady initially referred to respiratory clinic with symptoms of breathlessness. She had a high-resolution CT thorax where an incidental finding of a right para-oesophageal 2.4-cm soft tissue density at the level of the thyroid gland identified. A CT neck was performed for further evaluation again showed the soft tissue mass (26 mm×37 mm) situated to the right of the oesophagus and another mass (16 mm×26 mm) left of the oesophagus. Discu...

Current UK guidelines for thyroid nodules advise a thyroid ultrasound (ThyUSS) with U-Classification with or without Fine Needle Aspiration (FNA) with Thy-Classification to determine malignancy risk. We report four cases where thyroid carcinoma was diagnosed histologically following reassuring cytology and radiological examination. This is a case of 28-year-old female who presented with neck swelling. ThyUSS showed an enlarged left thyroid with cystic and solid components; FNA...

Diabetic nephropathy is the leading cause of chronic kidney disease and is responsible for 30–40% of all end stage renal disease (1). Where there is rapid decline in eGFR, we should also consider other aetiologies.This is the case of a 65-year-old Caucasian gentleman with complex presentation and novel management strategy with type 2 diabetes mellitus since 1999 which was effectively managed, evident by reasonable control of HBA1c; Pharmacotherapy r...

Adult endocrine specialist nursing (ESN) is a highly specialised role and in recent years nurses have expanded their roles according to local need (Kieffer.V, et al. 2015). As an Endocrine team we review our practice, striving to provide the highest standard of research based, patient centred care. This involves ensuring the best use of resources and service provision in an ever more demanding environment. A new initiative lead by the ESN with consultant supervision w...

The British Thyroid Association executive committee advised in 2015 that there was insufficient evidence that levothyroxine(T4) and liothyronine(T3) combination therapy was superior to levothyroxine monotherapy, which remains the standard treatment of primary hypothyroidism. It was considered an experimental approach in symptomatic patients on T4 therapy with a TSH level within normal range.We present a 47-year-old lady who had been diagnosed with primar...