Endocrine Abstracts

A 34 year old male, previously healthy nightclub doorman presented with 2 years of reduced libido, fatigue, hot flushes and reduced beard growth. He had fathered three healthy children. He admitted to previous use of veterinary anabolic steroids up until 2 years ago. He had normal secondary sexual characteristics, no features of pituitary hypersecretion, normal visual fields but reduced testicular volumes (8 ml).Biochemical investigation showed growth ho...

Alemtuzumab is the first humanised monoclonal antibody. It is used in haematological malignancies. It is associated with secondary autoimmune adverse effects including Grave’s disease, hypothyroidism, Goodpasture’s disease and ITP. We present a case where there was a drastic change in the thyroid biochemistry in a short span of few weeks- from raging free hormone levels to profound hypothyroidism. A 46 year old man was found to have abnormal th...

Introduction: Thyrotropin-secreting adenomas are a rare cause of hyperthyroidism. Preferred treatment is pituitary neurosurgery.Case report: A 35 year old lady was first noted to have abnormal thyroid function when presenting with an AV-nodal re-entry tachycardia in 2011. She had tremors, sweating and irritability. FT4 was 35 pmol/l (10-20 pmol/l) with a non-suppressed TSH level of 7.5 U/l (02–6 U/l). Previous meningococcal meninigitis ag...

Despite i.v. bisphosphonates, including pamidronate and zoledronate, representing the established agents used to reduce calcium levels, a proportion of patients with hypercalcemia either fail to respond to such treatments or relapse following their use.We present a case of hypercalcaemia refractory to conventional treatments that was treated with the use of the human MAB denosumab.A 70-year-old male presented to the emergency depar...

Denosumab is a MAB currently licensed for use in treatment of osteoporosis. It is designed to inhibit RANK ligand to prevent bone breakdown by osteoclasts. Its use for treatment of malignant hypercalcaemia is still to be fully investigated.We present the case of a 71-year-old south Asian gentleman with recurrent resistant hypercalcaemia secondary to follicular non-Hodgkin’s lymphoma. Calcitriol levels were elevated which was thought to be lymphoma r...

Introduction: Hypothyroidism remains a global problem with prevalence of 1–2% in iodine replete areas of the world. Primary or Autoimmune Hypothyroidism remains the most common type of hypothyroidism worldwide. Central (secondary) hypothyroidism (CH) because of pituitary/hypothalamic disorders is a rare cause of hypothyroidism with reported prevalence of 1:20.000 to 1:80.000 in the general population1. This makes CH about 1000 fold rarer than primary hypothyro...

Postural orthostatic tachycardia syndrome (PoTS) reflects a disturbance of autonomic function leading to a myriad of clinical features. Subcutaneous octreotide injections and intramuscular long acting preparations of octreotide have been used in the treatment of PoTS. However, inconvenience of frequent injections, side effects and theoretical overexposure, as well as cost of the intramuscular preparation, makes them far from ideal.We present a case of un...

Testosterone is frequently used by bodybuilders to increase muscle bulk. It is associated with polycythemia. We present a case of a bodybuilder with polycythemia vera taking testosterone injections presenting with a stroke.A 38 years old bodybuilder, a non-smoker was admitted with sudden onset of vertigo, slurring of speech and weakness of left leg. Symptoms resolved within few hours. He had a large right sided cerebellar infarct 9 years ago and few tran...

We have previously shown that β-endorphin reduces muscle fatigue and increases glucose uptake in contracting and non-contracting skeletal muscles of the mouse. The aim of this study was to compare the effect of these peptides on glucose uptake and muscle fatigue in normal mice and obese-diabetic mice (which provide a model for non insulin-dependent diabetes mellitus, NIDDM). The uptake of glucose into contracting and non-contracting muscle was assessed using the non-metab...

AimTo assess relationship between serum calcium level and localization studies and management outcome.MethodologyRetrospective analysis of data for patients referred by primary care for hypercalcemia from 1/3/2019 to 1/3/2020 to the Endocrinology department at Royal Berkshire Hospital. The sample size was 63 which excluded normo-calcemic hyperparathyroidism as well as MEN1/2 patients.Re...