Endocrine Abstracts

Objective: We report two cases of thyrotoxicosis with use of anti-thyroid medications via rectum in elderly patients where oral or naso-gastric route was unavailable.Discussion: Case 1: An 86-year-old woman was admitted in July 2007 with confusion associated with agitation and tachycardia. She had a known history of thyrotoxicosis. At the time of this admission, the TFTs were once again found to be abnormal (Table 1) and she was started on PTU. During ad...

We report a 47-year old lady who was initially diagnosed to have primary hypothyroidism nearly four years ago; on treatment with levothyroxine sodium (LT4) 150 μcg daily. Despite reasonable doses of LT4, and being fully compliant with her therapy, at no stage her TSH was less than 20 mU/L (Table-1). Malabsorption was ruled out and there were no clinical features to suggest this. When she was reviewed...

ObjectiveTo examine the relationship between leptin, adiponectin and insulin resistance in a group of men and women with varying degrees of glucose tolerance and obesity.Method69 participants were investigated and divided into four groups: 15 normal weight with normal glucose tolerance (NW NGT); 22 overweight with normal glucose tolerance (OW NGT); 15 overweight with impaired glucose tolerance (OW IGT); and 1...

Cushing’s syndrome is a rare endocrine disorder which the Royal College of Physicians/Society for Endocrinology Guidelines – Pituitary Tumours (1997) suggest should only be differentially diagnosed in centres with appropriate technical and enocrinological expertise. We conducted an audit against these guidelines of the management of Cushing’s syndrome in our unit (population covered 250, 000) over the 3-year period between January 2003 and January 2006. Aetiolog...

Diabetes mellitus, characterised primarily by hyperglycaemia, is associated with a number of cellular stresses and changes that cause cardiomyocytes to adapt with those modifications that characterise the diabetic heart. Although orexins are cardiovascular regulators acting via the brain, little is known about their potentially critical roles in the heart. Orexins exert their actions by activating two distinct G protein coupled receptors, orexin-R1 (OXR1) amd orexin-R2 (OXR2)....

Background: Nutritional data in NETs is lacking. There are a range of gastrointestinal issues which can be related to the NET, treatment, surgical intervention, or pre-existing diseases1. Many of these can have nutritional consequences or be improved through altering diet with the support of a specialist dietitian.From October 2018, a gastrointestinal specialist dietitian joined the weekly clinic for 12 months. The aim of the service evaluatio...

A 77 year old gentleman was referred to the endocrinology team following the incidental finding of an adrenal nodule on computer tomography (CT) colonography. Following this, dedicated CT of the adrenal showed a 4cm nodule with an attenuation of 30 Hounsfield Units. Biochemical investigation found no evidence of adrenal insufficiency or functional hormone production. Subsequent imaging by magnetic resonance imaging (MRI) and further CT showed stable appearances in size of the ...

Thyroid uptake scan is a widely used thyroid investigation that provides valuable information regarding the structure and function of the gland and helps in differentiating some of the common thyroid pathologies. We present a multicentre audit of thyroid uptake scans done for non-malignant thyroid pathologies and try to analyse the usefulness of this investigation in different situations.MethodsThis audit includes thyroid uptake sc...

BackgroundThyrotoxicosis with Graves’ Disease is treated with thionamide, radio-iodine treatment and thyroidectomy. Surgery is an important choice, especially when Graves’ Disease is complicated by thyroid orbitopathy. Pre- and post-operative protocols for thyroidectomy are imperative.Aims1) To assess pre-operative preparation of patients, with potassium iodide, vitamin D, beta blockade, and the pre...

Section 1: Case history: We present the case of a 21-year-old lady known to harbour a homozygous inactivating mutation of the calcium sensing receptor (CaSR) which led to uncontrolled hypercalcaemia in infancy, necessitating emergency total parathyroidectomy. The CaSR plays an important role in calcium homeostasis. Inactivating mutations result in a higher calcium “set-point” and various degrees of hypercalcaemia based on the severity of functional impairment. In the...