Endocrine Abstracts

Objectives: The aim of the study was to evaluate the normal reference values for thyroid uptake using Technetium-99 m (Tc-99 m) pertechnetate.Methods: Sixty-seven euthyroid patients with primary hyperparathydism who underwent parathyroid imaging with Tc-99 m pertechnetate between January 2012 to April 2014 at the Nuclear Medicine department, Newcastle upon Tyne Hospitals was studied. Electronic medical records and biochemical thyroid functi...

A 47-year-old female presented with facial swelling, easy bruising, and concern regarding possible Cushing’s syndrome. She had developed secondary amenorrhoea 3 years previously; biochemistry suggested hypogonadotrophic hypogonadism, felt to be hypothalamic secondary to low BMI and intense exercise. She was normotensive, and BMI was 17.4. There was no evidence of abdominal striae, proximal myopathy or hirsutism, but her face appeared rounder and plethoric compared with a ...

Case 1: A 65-year-old man was admitted with symptomatic hypocalcaemia (corrected calcium of 1.65 mmol/l, PTH 46.6 (1.6–6.8) pmol/l, and vitamin D 51.4 (50–150) nmol/l)) 5 days following denosumab initiation. He had a diagnosis of probable urothelial carcinoma with associated osteoblastic metastases, and 10 days prior to this admission had been treated for hypercalcaemia (corrected calcium of 3.04 (2.20–2.60) mmol/l) with i.v. fluids following which denosumab was...

A 31-year-old woman presented with oligomenorrhoea and a raised prolactin. Pituitary scan revealed a 1.8 cm pituitary mass with compression of the optic chiasm. TSH was normal at 3.66 mIU/l with a raised FT4 of 25.8 pmol/l. The rest of pituitary function was normal. Visual fields demonstrated a bitemporal upper quadrantanopia. A diagnosis of TSH-secreting pituitary adenoma was suspected because of the high normal TSH in the presence of a high FT4. She und...

: A 61-year-old gentleman was referred to the Endocrine team with acute bilateral adrenal haemorrhage. He had undergone a successful left popliteal embolectomy for critical limb ischaemia a week ago following which he was commenced on anticoagulation therapy. He presented to the Emergency Department with acute severe abdominal pain and low grade pyrexia of 37.6 C. He was haemodynamically stable. His International Normalised Ratio was noted to be elevated at 4.7. An urgent abdo...

We present the case of a 74-year-old man who was admitted with a short history of confusion and reduced mobility. He had a raised serum corrected calcium (cCa) of >5 mmol/l, serum parathyroid hormone (PTH) of 1.9 pmol/l (range 1.6–6.8 pmol/l) and acute renal failure. He was rehydrated and given a dose of i.v. zoledronate. Two days later his serum cCa remained elevated (4.39 mmol/l) with persistently impaired renal function. He underwent dialysis and serum cCa improved...

Introduction: Stiff person syndrome (SPS) is a progressive neurological disorder characterized by fluctuating stiffness and rigidity in both axial and limb muscles. Stiff leg syndrome, an SPS variant mainly affecting limb muscles, is emerging as a distinct identity. The cause of SPS is unknown but an autoimmune pathogenesis is suspected. There are a few reported cases of hypopituitarism presenting with features suggestive of SPS.Case: A 66-year-old woman...

Introduction: Maternal hypothyroidism is associated with an increased risk of complications both to the pregnant mother and the developing fetus. The 2007 American Endocrine Society Guidelines recommend a rapid titration of thyroxine dose to attain a target TSH concentration of ≤2.5 µU/mL in the 1st trimester (≤3 µU/mL in the 2nd and 3rd trimesters). Objectives Our aims were to assess the adequacy of thyroxine replacement in pregnant women with hypothyroi...

Similar to thyroid hormones, the calcineurin/NFAT pathway regulates bone mass via its actions in osteoblasts and by indirect effects on osteoclast function. Calcineurin is a calcium- and calmodulin-activated phosphatase that dephosphorylates the transcription factor NFAT enabling its translocation to the nucleus. RCAN2 is an inhibitor of calcineurin that is stimulated by T3 in brain, heart and skeletal muscle although its expression in bone has not been studied. Thu...

Transphenoidal surgery is an effective treatment option in patients with pituitary tumours associated with compression of the optic chiasm or hormone hypersecretion. Surgery carries with it a risk of the development of new pituitary hormone deficits but also the potential for recovery of existing pituitary hormone deficits. We have examined data concerning pituitary function in 80 patients who underwent endoscopic transphenoidal pituitary surgery at Royal Preston Hospital....