Endocrine Abstracts

Introduction: Parathyroidectomy is the treatment of choice for patients with primary hyperparathyroidism who have significant hypercalcemia and/or end-organ damage. The incidence of postoperative hypocalcaemia is 25–90% in patients with evidence of radiological evidence of parathyroid disease, 0–6% without. In most patients it is mild, but in some, it can cause significant morbidity. It has been attributed as ‘hungry-bone syndrome’ and attempts have been ma...

Carcinoid tumours are the commonest neuroendocrine tumours (50%), with a prevalence of 3–5/100,000. 10% present with carcinoid syndrome due to release of kinins and serotonin, released directly from the tumour in to the blood or due to liver metastases. Carcinoid heart disease due to ovarian carcinoid is extremely rare. Here we present such a case. A 69 year old female presented to surgeons with increased bowel frequency and weight loss. Blood tests, colonoscopy and biops...

Introduction: Hypocalcaemia secondary to post-operative hypoparathyroidism is a recognised complication of thyroid surgery with reported rates of up to 75%. Little guidance exists on the appropriate management of post-operative hypocalcaemia and individual clinicians may develop their own preferred management strategies based on past experience. However, delay in restoring normocalcaemia may increase length of hospital stay and patient morbidity.Aims: i)...

Background: Recent evidence favours the use of TRAB in patients with hyperthyroidism (a) at presentation to identify the aetiology and predict outcomes (b) at the time of withdrawal of medical therapy to predict remission and (c) during pregnancy. However, If TRAB is not requested at an appropriate time, it may not help, may mislead or add to cost.Aim: To review the current process of requesting TRAB in line with available evidence and identify areas for...

Presentation: A 32-year-old woman was brought to the Emergency Department following an out-of-hospital cardiac arrest. CPR was started by a neighbour and on arrival, she was found to be in ventricular fibrillation (VF). She received 4 DC-shocks and reverted to atrial fibrillation with fast ventricular rate and staged a full cognitive and haemodynamic recovery. She had a 10-year history of Graves’ thyrotoxicosis for which she was on Carbimazole but remained uncontrolled du...

Respiratory muscle weakness and diaphragmatic failure is a rare presentation of hypercortisolism. We report a case of Cushing’s syndrome in a 60-year-old female with history of rheumatoid arthritis, biliary cirrhosis and hypothyroidism. She presented to the Respiratory Physicians with progressive worsening of shortness of breath. Clinical assessment excluded infective pathology, cardiac failure or asthma. Pulmonary function tests (PFT) showed re...

Respiratory muscle weakness and diaphragmatic failure is a rare presentation of hypercortisolism. We report a case of Cushing’s syndrome in a 60-year-old female with history of rheumatoid arthritis, biliary cirrhosis and hypothyroidism. She presented to the Respiratory Physicians with progressive worsening of shortness of breath. Clinical assessment excluded infective pathology, cardiac failure or asthma. Pulmonary function tests (PFT) showed re...

Background and Aim: RAIT has a high success rate in achieving cure of hyperthyroidism but there is unpredictability of thyroid status during the initial post-RAI period, making it difficult to counsel patients or plan medical therapy. We assessed the role of updated TRAB level at the time of RAIT in predicting persistent post-RAI hyperthyroidism.Patients and Methods: We measured TRAB at the time of RAIT (fixed 550MBq dose) in 26 patients with Graves&#146...

Background: There has been conflicting evidence on the use of strict dietary iodine restriction prior to Radioiodine (RAI) administration for the management of hyperthyroidism and varying level of restrictions have been used. More recently the Medical Physics team in our institute implemented strict dietary iodine restrictions for 2 weeks pre-RAI administration. Significant inconvenience was reported by patients, which in some instances led to their reluctance to receive a sec...

A 30-year-old lady presented with three episodes of generalised seizures, paraesthesiae, irritability, and intermittent confusion since her first delivery 5 months ago. Over the past 3 weeks, she had developed exertional dyspnoea and easy fatigue. She was previously fit and well and the recent delivery was eventless. On examination, she demonstrated carpopedal spasm and other typical features of hypocalcaemia. Serum calcium was 0.88 mmol/l (2.10–2.55), magnesium 0.63 mmol...