Endocrine Abstracts

A 36-year-old male presented to the emergency department with a 24-hour history of mutism, paranoia and 3-day history of social withdrawal. He was unable to engage with healthcare professionals and the history was elicited from his mother. Due to a background of mild depression, an acute psychotic diagnosis was initially pursued. A CT scan on admission revealed a large pituitary lesion. A pituitary MRI scan thereafter demonstrated a large 25 × 30 × 18 mm sellar and s...

Primary hyperparathyroidism (PHPT) is a common condition, affecting approximately 1% of the general population. In women of childbearing age, the correct diagnosis and management is particularly important since PHPT is associated with miscarriage, pre-eclampsia, intrauterine growth restriction, preterm delivery and postpartum neonatal hypocalcaemia. We describe a case series of six women diagnosed with PHPT and their management during pregnancy. In four cases, the PH...

A 27 year old lady with Graves’ thyrotoxicosis (fT4 50.3 pmol/L, fT3 25.0 pmol/L, TSH<0.05 mU/L) failed to respond adequately to carbimazole (40 mg BD) or propylthiouracil (250 mg QDS). Three months later, following 10 days of potassium iodide to render her biochemically euthyroid, she underwent a total thyroidectomy. Pre-operative bone profile revealed Ca(c) 2.34 mmol/L (NR 2.15–2.60 mmol/L), phosphate 1.36 mmol/L (NR 0.8–1.4 mmol/L), PTH 3.4 pmol/L (NR 1.1...

Background: Chromaffin cell tumours are rare but potentially curable endocrine tumours. These tumours may be sporadic or familial in nature. Biochemical tests are normally performed initially, followed by radiological investigation.Aim: To assess the correlation of biochemical and radiological investigations with histologically proven chromaffin-cell tumours in patients with sporadic and familial disease.Methods: We retrospectively...

A 31-year-old engineer presented with a 6-week history of tremor, weight loss, mild goitre and palpitations. At the onset of these symptoms, he also presented to a specialist eye hospital for difficulty with focussing his vision. He had no past medical history and was taking no medications. He did not have any family history of ocular or autoimmune conditions and was a non-smoker. On examination his BMI was 20, he had very mild proptosis, no diplopia and a diffuse symmetrical ...

A 47-year-old afrocaribbean lady was referred to endocrinology clinic with a 1-month history of weight loss, heat intolerance, palpitations, fatigue and hair loss. She reported symptoms consistent with proximal myopathy including myalgia and difficulty rising from chairs. Interestingly she noted a 1-month history of hypersalivation, which had caused her significant distress in her social and work life. The hypersalivation had resulted in a change in her voice and had also inte...

Background: Hypercalcaemia is defined as an elevated serum calcium level above 2.6 mmol/l and occurs in 1 in 1000 of the population. It commonly results from primary hyperparathyroidism (PHP) which is usually treated with parathyroidectomy. A less common cause of hypercalcaemia is familial hypocalciuric hypercalcaemia (FHH) which is caused by mutations inactivating the calcium-sensing receptor; however FHH is relatively benign and requires no treatment. It is clearly important...

A 19-year-old man was referred to Endocrinology Clinic with a minimally raised calcitonin level. He had a past history of primary hyperparathyroidism resulting in renal colic aged 17 years, and underwent three gland parathyroidectomy aged 18 years. Histology demonstrated a single right lower parathyroid adenoma with normal thyroid biopsy. He has no family history of endocrine disease and is a non-smoker. His calcium has remained normal since with detectable PTH. Over 5 years t...

We present a 44-year-old female referred to us with a two year history of episodic palpitations, chest tightness, headaches and pallor associated with hypertension. She had previously been extensively investigated by neurologists and cardiologists including MRI of the brain, renal ultrasonography, 24 h tape and echocardiography – all normal. Given the history, a CT of the adrenals was performed in 2007 which revealed a 1.5 cm nodule in the right adrenal with abnormal enha...

A 37-year-old lady was referred to the endocrine clinic with a raised serum calcium of 2.73 mmol/l in the presence of an inappropriately raised parathyroid hormone of 8.7 pmol/l. Calcium:creatinine clearance ratio was elevated at 0.018, excluding familial hypercalcaemic hypocalciuria. Past medical history revealed an episode of renal stones 17 years ago but a renal ultrasound excluded nephrocalcinosis.A diagnosis of primary hyperparathyroidism was made.<...