Endocrine Abstracts

Succinate dehydrogenase subunit B (SDHB) mutations are associated with a high risk of developing pheochromocytomas, paragangliomas and renal cell tumours. The risk of malignancy is also higher than that of other SDH mutations.A 23-year-old woman was referred to endocrine clinic following confirmation of an SDHB mutation. Her family was screened when a relative underwent a medical, prior to starting a new job, and a significant family history of renal tum...

Introduction: Significant hyponatraemia (serum sodium <128 mmol/l) is a potentially modifiable cause of prolonged hospital length of stay (LOS). By correcting euvolaemic hyponatraemia more rapidly than imposed fluid restriction, vasopressin receptor-2 antagonists may be useful adjuncts to existing treatments.Aim: To explore the potential clinical utility of vasopressin antagonists by describing the frequency and nature of hyponatraemia typically enco...

Case History: An 84-year-old women presented to a psychiatric unit with a 5-month history of fluctuating confusion, paranoid behaviour, anxiety, reduced cognition and unsteadiness. There was no history of galactorrhoea, headache or visual field disturbance. Past medical history included hypertension, chronic kidney disease, congestive heart failure, premature menopause and hyperlipidaemia. She had been taking bendroflumethiazide, furosemide, mirtazepine and sulpiride. A CT hea...

Introduction and aim: An e-mail based GP advisory service was launched by the authors’ centre in 2005. The PCT commissioned the service in July 2009. Enquiries are handled by specialist registrars with consultant supervision. The charge is £23/enquiry.Pre-commissioning, annual audits demonstrated an efficient and popular service, enhancing communication links between primary and secondary/tertiary care.We re-audited the s...

Case: A 73-year-old lady presented with hyponatraemia six days post-transphenoidal surgery for a non functioning pituitary macro-adenoma. Peri-operatively she developed diabetes insipidus requiring short term desmopressin whilst on the neurosurgical ward. At post-operative presentation she complained of weakness, confusion and nausea; sodium 125 mmol/l, serum osmolality 268 mOsmol/kg, urine osmolality 474 mOsmol/kg. Over the next few days she became symptomatically worse and h...

Background and case: A 38-year-old man presented acutely with left-sided retro-orbital pain, a heavy/numb sensation in his left arm and blurred vision and diplopia on left lateral gaze. Baseline biochemistry, liver function and haematology were normal. His TSH was 3.9 (0.3–4 mU/l) and CRP 92 mg/l (<10). Plain CT head was unremarkable as was the MRI as reported, and atypical migraine was suspected. Vertical diplopia on left lateral gaze and left upper arm paraesthesia ...

Introduction: Dopamine Agonists are important in the management of endocrine disorders such as acromegaly and hyperprolactinaemia. Recent studies have shown that Cabergoline used in high doses to treat Parkinson’s disease is associated with cardiac valve fibrosis.Methods: We identified patients on long term high-dose cabergoline for the management of acromegaly. The following data was analysed: demographic data, duration of treatment, cumulative dos...

Introduction: Riedel’s thyroiditis is a rare disorder of unknown aetiology and may be seen isolated or as a part of multifocal fibrosclerosis. Multifocal fibrosclerosis involves two or more fibrotic disorders including Riedel’s thyroiditis, retroperitoneal fibrosis, sclerosing mediastinitis, retro-orbital pseudotumour and sclerosing cholangitis. We report a case of recurrent Riedel’s thyroiditis as part of multifocal fibrosclerosis presenting with a woody neck s...

Introduction: It is well known that struma ovarii, choriocarcinoma and follicular thyroid carcinoma can cause thyrotoxicosis. We report a rare case of a man with carcinomatosis presenting with acute thyrotoxicosis, unilateral proptosis and neck swelling.Case report: A 48-year-old man presented with a 2 weeks history of neck swelling, profuse sweating, heat intolerance, agitation, weight loss and mild unilateral proptosis. He was a smoker with a 20 years ...

Adrenocortical carcinoma is extremely rare and accounts for 0.05–2% of all malignant neoplasms with an estimated incidence of 0.5–2% per million people per year. Feminising adrenal carcinoma is even rarer. We submit such a rare case presenting with gynaecomastia.A 50 year old man presented with a year history of increasing bilateral gynaecomastia. He had no problems with his sexual function. Initial investigations by the GP showed low testoster...