Endocrine Abstracts

Radioactive iodine is used routinely and safely in the treatment of hyperthyroidism. We describe an unusual side effect after a single treatment in a patient with subclinical hyperthyroidism.A 64 year old woman was referred to our service with multinodular goitre. She was found to have subclinical hyperthyroidism with TSH 0.17 mU/L, fT3 5 pmol/L and fT4 14 pmol/L. She underwent radioactive iodine treatment with 530 MBq of Iodine -131 in Jan...

Background: Type 1 diabetes (T1D) is a metabolic disease of unknown aetiology that results from the autoimmune destruction of the insulin-producing pancreatic β-cells. Exogenous insulin administration is the only treatment for patients. Partial remission or “honeymoon phase” classically occurs a few weeks after insulin therapy has been initiated. During this stage the patient’s need for exogenous insulin can decline by 50%, and near-normal metabolic control...

A 39-year-old lady with background history of autoimmune hypothyroidism diagnosed over 10 years ago, established on Levothyroxine 100 mg once daily, was referred by the GP with unusual sweating, palpitations, tiredness, anxiety, tremors and weight loss of around one stone over last few months. The thyroid function tests were suggestive of thyrotoxicosis with TSH of less than 0.05 mu/land FT4 60 pmol/l, hence the dose of levothyroxine was gradually reduced and ultimately stoppe...

Case history: A 65 year-old Caucasian gentleman was admitted with out-of-hospital VF arrest at work place. ROSC was achieved after shock by paramedics but developed multiple in-hospital arrests requiring (>100 shocks in 24 h) with incessant polymorphic ventricular tachycardia which was resistant to anti-arrhythmic therapy including drugs and pacing. Investigations revealed hypercalcemia and newly diagnosed high PTH with no change in mild LV dysfunction from previous myocardial...

15-year-old girl presented to the psychiatrist with behavioural problems, fluctuation in mood, paranoia, low self-confidence and school refusal. She presented to her GP 4 months later with history of increased body hair and irregular menstrual pattern. Her sex hormone binding globulin was low. Luteinising hormone, follicular stimulating hormone and testosterone levels were normal. Pelvic ultrasound showed both ovaries contain multiple follicles suggestive of polycystic ovary d...

We report two cases of severe hypocalcaemia developed after intravenous administration of pamidronate in patients with severe hypercalcaemia secondary to multiple myeloma. Both of them develop symptomatic hypocalcaemia few days after treatment. Both patients was probably vitamin D deficient (both serum 25-hydroxyvitamin D level was low less than 15 (NR 25–120 nmol/l) because of a combination of poor oral intake, inadequate sunlight exposure, and the development of renal f...

Background: Thyrotoxicosis can present as heart failure, especially in elderly patients. We report a case of thyrotoxicosis causing reversible right-sided heart failure.Case: A 75-year-old Caucasian lady presented with a month’s history of shortness of breath, abdominal distension and ankle oedema. She complained of hot sweats with palpitations, On admission, she was thyrotoxic with evidence of severe right sided heartfailure.Her ECG showed fast atr...

We had a 29 year old lady with 11 years history of hirsutism and amenorrhoea. She was diagnosed as polycystic ovarian syndrome in a different hospital few years ago and commenced on metformin and spironolactone. She noticed worsening of hirsuitism over last year, needing to shave daily, along with loss scalp hair, deepening of voice and clitoromegaly. On examination, she was obese without any overt signs of Cushing’s syndrome. She had severe hirsuitism affecting face, arm...

We had a 67-year-old lady who presented with 2-week history of shortness of breath and dry cough. Her past medical history includes dense left sided hemiplegia from previous stroke, hemiarthroplasty for fracture neck of femur, hypertension and osteoporosis. She had a large goitre for many years without any recent change in size of the goitre and there was no history of dysphagia. She had a large goitre with engorged neck veins, but no palpable lymph nodes. Her Chest X-ray show...

Young man with high BMI and known iatrogenic hypothyroidism, post radioactive iodine (RAI) treatment (2015) for Graves’ thyrotoxicosis (2011) was referred to endocrinology due to significantly raised TSH (at 50 mu/l) and low FT4 (5.0 pmol/l). He was actually admitted with progressive nausea, vomiting over last three weeks. He also complained of abnormal stool consistency (like semi-solid) intermittently. His past medical history also includes gastric bypass with gastro-je...