Endocrine Abstracts

A 19-year-old man was referred to Endocrinology Clinic with a minimally raised calcitonin level. He had a past history of primary hyperparathyroidism resulting in renal colic aged 17 years, and underwent three gland parathyroidectomy aged 18 years. Histology demonstrated a single right lower parathyroid adenoma with normal thyroid biopsy. He has no family history of endocrine disease and is a non-smoker. His calcium has remained normal since with detectable PTH. Over 5 years t...

We present a 44-year-old female referred to us with a two year history of episodic palpitations, chest tightness, headaches and pallor associated with hypertension. She had previously been extensively investigated by neurologists and cardiologists including MRI of the brain, renal ultrasonography, 24 h tape and echocardiography – all normal. Given the history, a CT of the adrenals was performed in 2007 which revealed a 1.5 cm nodule in the right adrenal with abnormal enha...

A 27-year old Caucasian woman was referred to the Endocrine Bone Clinic after investigations for general malaise revealed hypercalaemia and elevated parathyroid hormone levels. She had no history of constipation, abdominal pain, bone pain, or other related symptoms. She had no history of renal stones or fractures and no change in weight. Her past medical history included asthma and she took a salbutamol inhaler as required. She had no family history of endocrine pathology. Gen...

Ectopic adrenocorticotropic hormone (ACTH) production is a rare cause of Cushing’s syndrome. It is usually seen with small cell lung cancer, bronchial carcinoid, or medullary thyroid cancer. Rarely, the source of ectopic ACTH production can be a phaeochromocytoma. A 55 year old gentleman presented to a general physician following an episode of presumed gastroenteritis with vomiting and general malaise. Further episodes of diarrhoea, joint pains and palpitations followed. ...

Introduction: Sporadic primary hyperparathyroidism (sporadic PHPT) is a common endocrine disorder, usually caused by a single parathyroid adenoma. However, up to 15% of patients present with multiple gland disease (MGD), which cannot be always diagnosed preoperatively, raising serious management problems. No predictive genetic screening tests are currently available to distinguishing adenomas from MGD in sporadic PHPT. MiRNAs are widely established as genetic molecules that ha...

Case history: We report a 56-year-old man who was referred to the Endocrinology Clinic with hypokalaemic hypertension. He had a history of bladder cancer 9-years previously, treated with surgery, chemotherapy and BCG therapy. At referral, he was taking Amlodipine 10 mg and Doxazosin 8 mg twice daily with average home blood pressure readings of 160/90 mmHg.Investigations: Aldosterone to renin ratio (ARR), taken on Doxazosin with potassium 3.6 mmol/l was 3...

A 60-year-old Caucasian lady was referred to the metabolic bone clinic for assessment of osteoporosis. Her risk factors for osteoporosis included gender, postmenopausal status, childhood immobility due to illness, previous severe vitamin D deficiency, COPD, as well as an extensive smoking and alcohol history. She had multiple previous fragility fractures involving her ribs and both radii. A DEXA scan revealed lumbar osteoporosis (T -4.0) and femoral osteopenia (T -2.0). Thorac...

Phaeochromocytomas (PCC) and paragangliomas (PGL) are rare tumours derived from the sympathetic or parasympathetic paraganglia. They characteristically secrete catecholamines (noradrenaline/adrenaline/dopamine), which are metabolised to the metanephrines (normetadrenaline/metadrenaline/3-MT respectively). These tumour markers can be detected in acidified 24-h urine collections as first-line investigative tests. Plasma 3-MT has been characterised as a biomarker of metastatic PG...

A 38-year-old man presented on the acute medical take with a week’s history of sore throat, dysphagia, neck swelling, and fever. One month prior he had suffered a respiratory tract infection, which resolved without antibiotics. He had no notable past medical and family history. He was a non-smoker and drank 15 units of alcohol per week. On examination he looked well, was afebrile, sweaty and flushed; chest was clear, heart sounds were normal, regular pulse (110 bpm) and B...

Background: Vitamin D deficiency is a common feature of primary hyperparathyroidism (PHP). However, replacement of vitamin D is not routinely performed in clinical practice, due to concerns about its safety. Furthermore, it is not clear whether vitamin D deficiency worsens the biochemical derangements observed in patients with PHP.Aim: To determine the relationship between 25(OH) vitamin D status and biochemical markers in patients with PHP.<p class=...