Endocrine Abstracts

Objectives: To evaluate outcomes post radioiodine (I-131) therapy for hyperthyroidism at a tertiary hospital in a two-year period.Method: The local database (Leicester Clinical Workstation) was used to identify patients with hyperthyroidism who had received radioiodine therapy (RAI) between January 1st 2010 and December 31st 2011 and their records were retrospectively analysed.Results: 84 patients were identif...

Background: Pituitary adenomas commonly present with palsies involving the cranial nerves in the cavernous sinus. It is unusual, however, for other cranial nerve palsies to co-present and to have biochemical results that do not fit with the clinical picture.Case: A 47 year old man was admitted with 3 days of headache, vomiting, right sided facial paraesthesia and facial droop. He had no symptoms suggestive of endocrine disturbance. Neurological examinati...

Clinical presentation: This 32 year old lady was referred with a history of weight loss, sweating, tremor and anxiety and biochemical hyperthyroidism; fT4 41 pmols/l (9.00–25.00 pmols/l) TSH <0.05 miu/l (0.30–5.00 miu/l); strongly positive TPO antibodies (1600 IU/ml.). She was toxic clinically, had subtle left sided proptosis and a palpable left sided thyroid nodule. She was started on carbimazole 20 mg and the initial differential diagnosis was between Grave&#14...

Background: A large proportion of patients who attend the Endocrine clinic have thyroid dysfunction, usually thyrotoxicosis. These patients require regular thyroid function tests (TFTs) and advice on medication dose alteration, usually through frequent clinic appointments. At our University Teaching Hospital, we have a nurse-led system whereby TFT monitoring and advice is managed virtually, with patients usually attending clinic annually for review. We call this the Thyroid Sh...

Introduction: An insulinoma is a rare neuro-endocrine tumour originating in the pancreatic beta-cells with unregulated secretion of insulin resulting in profound hypoglycaemia.Methods: A search of electronic hospital records identified all patients with a primary diagnosis of insulinoma. Clinic and discharge letters, radiology investigations, laboratory investigations and case notes were reviewed to highlight the presentation, investigations and laborato...

Background: There is much debate about the best imaging modality for parathyroid adenoma. Parathyroid ultrasound is operator dependent and in skilled hands leads to localisation of tumour. Small adenomas can be difficult to detect and radiologists are helped by clinical and biochemical data to predict ease of adenoma detection. We investigated whether any factors could predict adenoma size.Methodology: This was a retrospective CWS analysis of patients wh...

Imaging in paragangliomas can be challenging as they arise from a number of locations including the adrenals, abdomen, pelvic and thoracic sites of chromaffin sympathetic tissue. They can also arise in the head and neck at sites of parasympathetic tissue. They are considered within the group of heterogenous neuroendocrine tumours. In addition to manifesting at multiple sites, they can metastasise, have variable expression of catecholamines and can be a manifestation of heredit...

Objective: Biochemical assessment of male hypogonadism relies on estimation of freely available testosterone. Gold standard measurement is by equilibrium dialysis but this is not practical in clinical use. We compared two calculation methods; bioavailable (non-SHBG bound) testosterone (Morris et al.), and free (non-SHBG non-albumin bound) testosterone (Vermeulen et al.) for their diagnostic performance.Design: Free testosterone and bioa...

A 73-year-old independent female presented with reduced consciousness following a tonic-clonic seizure. Investigations revealed acute hyponatraemia, with a serum sodium of 103 mmol/l. Cortisol reserve and thyroid function was normal and the biochemical diagnosis was consistent with SiADH. A CT brain scan was normal. Hypertonic saline was commenced with empirical anti-viral and antibiotic therapy. Lumbar puncture revealed a slightly elevated CSF protein and her EEG showed non-s...

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...