Endocrine Abstracts

Background: A 52-y-old lady (Mrs M) presented with a 10-day history of progressive generalised weakness, dysarthria and un-coordination. 26 y ago, she had cervical carcinoma, requiring a hysterectomy, oophorectomy and radiotherapy. This led to a vesicovaginal fistula, requiring a cystectomy and ureterosigmoidostomy. She is known to have osteoporosis. Medications: calfovit D3 one/d (started 5 days prior to admission), risedronate, lansoprazole. She had HRT until 50 y. Examinati...

Hydrocortisone day curves, Salivary cortisols, timed urinary free cortisols and 24 hour urine cortisols have been used to estimate hydrocortisone replacement in hypoadrenal patients.We looked at 39 patients who had hydrocortisone day curve estimations in our hospital. 35 of those patients had simultaneous 24 hour urine free cortisol estimation. All hypothyroid patients were on adequate replacement dose of thyroxine.The commonest cl...

Brown tumours (osteitis fibrosa cystica) are the classic bone disease of hyperparathyroidism. Parathyroid carcinoma is an uncommon cause of PTH dependent hypercalcaemia. We present the case of a 63-year-old man who presented to the ENT department with persistent right-sided nasal obstruction and nasal swelling. He was otherwise asymptomatic. He had a long history of nasal polyps, which had recently been resected. Brown’s tumour of the maxilla was demonstrated on nasal bio...

Thyroid cancer is rarely seen in the hyperthyroid patient.We present the case of a 59 year-old lady who presented with marked weight loss of more than 30 kg in less than 6 months, lethargy, palpitations and sweats. Clinically she was obese and thyrotoxic with sweaty palms and a tachycardia. No goitre or neck masses were detected. Thyroid function tests confirmed thyrotoxicosis with free T4 89.1 pmol/l (Normal range 9.8–23.1), free T3 20.2 pmol/l (No...

Graves' disease appears to be the clinical result of an autoimmune attack on thyroid tissue however the immune defect and triggering events remain unclear. The inflammatory process in multiple sclerosis (MS) is mediated by CD4 T lymphocytes. Campath-1H, a monoclonal antibody against the CD52 antigen of CD4 T cells, improves disease activity in MS and is associated with development of Graves' disease in one-third of patients. Thus Campath-1H provides an interesting insight into...

Background: Stress-related illness is commonly referred to the endocrine clinic, and often becomes a diagnosis of exclusion after extensive investigation. We provide evidence that a positive clinical diagnosis can be made without risk of missing organic illness.Methods: 101 consecutive and unselected referrals for ‘fatigue ?endocrine’ between 1/4/95 and 30/3/99 were identified from an endocrine clinic database (81 female, 20 male; mean age 41...

The glucagon stimulation test (GST) is used as a provocative test of the hypothalamic pituitary adrenal axis (HPAA) but the response to this test is variable and the mechanism of action remains unclear. The GST has never been studied in diabetic patients with autonomic neuropathy (AN). We illustrate the assessment of cortisol response in two diabetic patients with AN who were suspected of having adrenocortical deficiency. Case one: A 40 year old type 1 diabetic suffers from di...

Section 1: Case history: A 62 year old man presented with a three month history of abdominal bloating and discomfort, loose stools and weight loss. This progressed to hypoglycaemic symptoms that occurred initially after exercise. Symptoms included confusion and light-headedness, fatigue, cold sweats and shakiness. The patient had to eat regularly to prevent hypoglycaemia which resulted in weight gain. Hypoglycaemic episodes increased in frequency to the point where the patient...

Empty sella is an incidental finding characterised by the herniation of subarachnoid space into the sella turcica with resultant flattening of pituitary gland to varying extent. It was considered benign. But recent reviews have shown its association with some neuroendocrinopathies.Aims and Objectives: To determine if patients with radiological diagnosis of PESS were;1. Referred to Endocrinology team?2. What p...

Introduction: The study aim was to compare serial Short Synacthen test (SST) results to diagnose secondary Adrenal Insufficiency (AI) in patients with confirmed pituitary diseases.Methods: Serial SST results of patients, tested between 2006 and 2018 in the department of Diabetes and Endocrinology, at a tertiary centre, were reviewed retrospectively. Patient details were obtained from local dynamic test database, maintained by Endocrine Nurse Specialist. ...