Endocrine Abstracts

Normal range glycemia towards higher side has been shown to have a higher risk than lower range of glycemia(1).People with impaired glucose tolerance (IGT) with better glycemic control would be an ideal step towards prevention of coronary heart disease CHD.Prevalence of undiagnosed diabetes remains high(2). Diagnosis of diabetes is made too late in too many patients. By the time diagnosis is made complications have already settled ...

Background: Immune checkpoint inhibitors are now commonly used in melanoma, renal cell carcinoma and non-small cell lung cancers. Patients on immune check point inhibitors experience at least one type of immune related adverse event(irAEs) which can occur even after discontinuation of therapy. Endocrine toxicities are commonly reported irAE′s and tend to be irreversible. The most frequently recognized endocrine complications include thyroid dysfunction (30%) hypophysitis...

64 years old lady with history of breast cancer (post lumpectomy followed by radical mastectomy) received chemotherapy with Epirvlacin 140 mg and cyclophosphamide 600 mg 1 day prior. Past medical history included hypertension on ramipril and type 2 diabetes on diet control. Bloods on day of chemotherapy normal particularly sodium 135 mmols/l. Presented in 18 hours after 20 seconds tonic clonic seizure noted by family followed by abnormal flexion. Presented with GCS 7 which the...

Case History: 38 year old male presented with thyrotoxic symptoms and exophthalmos with an initial Free T4 of > 100 pmol/l; TSH < 0.01 mIU/l and thyroid receptor antibody positivity. He had a platelet count of 72* 109 /L at presentation and was started on carbimazole. A month later he had platelet count of 9* 109 /L with normal white cell count and haemoglobin levels. He was switched to propylthiouracil, but was readmitted with platelet count of 1...

An 84 year old female with a known history of chronic kidney disease (stage IV) and benign lung tumour presented to the Emergency Department with collapse. She had suffered recurrent collapse over the previous 2 years. Of note she reported significant weight gain during this period. She was diagnosed with symptomatic hypoglycaemia (venous blood glucose 2.8 mmol/l). She was admitted to the ward and found to have recurrent hypoglycaemia both when fasting and post-prandial.<p...

Introduction: Periodic paralysis is a rare condition characterized by muscle weakness in the presence of triggers including cold, heat, high carbohydrate meals or physical activity. It is classically described in the presence of profound hypokalaemia; when this occurs in conjunction with thyrotoxicosis it is termed thyrotoxic periodic paralysis.Case history: A 30-year old Nigerian man presented with a 3 h history of inability to move, on a background of ...

Introduction: Radioiodine is a safe and effective treatment for benign thyroid disease. It aims to treat hyperthyroidism and achieve a euthyroid state. Radioiodine is indicated in cases of hyperthyroidism caused by Graves’ disease or toxic goitre (solitary toxic adenomas or multi-nodular goitre). In practice there has been concerns about long term safety, worsening of eye disease and weight gain with this treatment.Aims: To audit outcome, management...

Objective: A review of the efficacy and safety of radioiodine treatment for Graves’ disease.Methodology: Patients were identified following a search of the nuclear medicine departmental database. Consecutive patients who had radioiodine in 3-year period from January 2009 to December 2011 were included in the audit. Information was obtained from medical notes, blood results and nuclear medicine database. Data was analysed using Microsoft Excel.<p...

Background: Peri-operative glucocorticoids are routinely administered to patients undergoing trans-sphenoidal surgery for non-functional pituitary adenomas (NFPA) irrespective of the integrity of hypothalamic-pituitary-adrenal (HPA) axis.Aim: To evaluate HPA axis before and three months after endoscopic trans-sphenoidal adenomectomy (E-TSA) in patients with clinically NFPA utilizing 1 mg ACTH stimulation test and determine the need for glucocorticoid adm...

Introduction: COVID 19 is now a global pandemic. Oxygen saturation (SpO2), male gender and diabetes have been associated as risk factors for critical care admission, intubation, and prolonged intubation in hospitalised patients. Bacillus Calmette-Guérin (BCG) vaccine may have protective role of against COVID-19Methods: We retrospectively evaluated inpatient records, of patients admitted over last three months in a public hospital in Northern India t...