Endocrine Abstracts

A 50 year old male presented with left visual field loss, afferent pupillary defect and reduced libido in 1999. Initial pituitary profile showed prolactin 130 000 mu/l (55.4–276), and testosterone was 5 nmol/l (10–27.6). MRI pituitary showed giant pituitary macroadenoma compressing chiasm. He was started on Cabergoline with subsequent improvement in visual fields, prolactin levels and size of adenoma on subsequent MRI. His disease remained stable on ...

A 58-year-old lady presented to hospital with abdominal pain, nausea, and tiredness, and was referred to endocrinology with symptomatic hyponatraemia (serum Na+ 112 mmol/l). Six months previously her serum sodium was normal. She was euvolaemic, and adrenal insufficiency and thyroid dysfunction were excluded. Laboratory investigations were suggestive of syndrome of inappropriate antidiuretic hormone (SIADH) and no causative medications were identified. A CT of her th...

Background: In steroid dependent patients the knowledge of steroid dose change during illness and stress is of paramount importance.Objectives: i) To assess patient’s knowledge of steroid management during acute illness and stressful condition. ii) To evaluate whether there is a relation between patient knowledge and admission with documented adrenal crisis. iii) To improve medical access to information about patients on steroid at Emergency Departm...

Introduction: Hypothyroidism is a common endocrine disorder worldwide. Its treatment is with oral thyroxine, but when this route cannot be utilised then intravenous thyroxine is an alternate but not available in some countries so rectal thyroxine administration can be used but clinical experience is lacking.Case report: This is a case of a 55-years-old Pakistani male known case of hypothyroidism since July 2007 and was maintaining normal TSH and FT4...

A 59-year-old gentleman presented to the Medical Admission Unit with facial and ankle oedema following a dog bite. He did not have any significant past medical history. Initially, he was treated for angioedema. His oedema worsened to anasarca, blood pressure rose and was found to be hypokalaemic. Echocardiogram showed a normal left ventricular ejection fraction. Urine protein creatinine ratio was <0.5 g/24 h. Vasculitic and autoimmune screen were negative. Eight weeks late...

A 35-year lady with Grave’s disease and brittle asthma presented to the Endocrinology team with symptoms and signs of thyrotoxic crisis. She was not on any anti-thyroid medication as she had previous suffered a severe rash in response to carbimazole, and profound gastrointestinal disturbance with propylthiouracil. It was suggested that she consider radioiodine to control her condition, but as a single parent with young children she was not prepared to undergo the isolatio...

Our goal is to better understand the molecular and cellular nature of paediatric combined pituitary hormone deficiency diseases in order to facilitate improved diagnosis, treatment, and family counselling. LIM-homeodomain transcription factors regulate many aspects of development and mutations in the genes that encode these regulatory proteins are associated with several diseases. The LHX3 LIM-homeodomain protein is critical for pituitary gland organogenesis and some nervous s...

LHX3, a member of the LIM-homeodomain family of developmental transcription factors, is required for establishment of mammalian anterior pituitary hormone-secreting cell types as well as the formation of specialized neurons of the nervous system. Paediatric patients with pituitary insufficiency are sometimes diagnosed with combined pituitary hormone deficiency disease (CPHD). This disease can be linked to mutations in essential pituitary developmental transcription factor gene...

Background: Insulin, derived from a single chain precursor pro-insulin, is cleaved by convertases to form insulin (t1/2 – 4 min) and C-peptide (t1/2 – 30 min). The ratio of insulin to C-peptide levels, which is usually less than one, is reversed in presence of exogenous insulin and insulin autoimmune syndrome. We present the significance of insulin-C-peptide ratio (ICR) in the diagnostic algorithm for the investigation of endogenous hyperinsulinaemia.<p class="ab...

Back ground: Radio iodine treatment is widely used in the management of hyperthyroidism. Recent guidelines have stressed the importance of advising patients of the recommendations with regard to radiation protection, and the implications of radioiodine treatment in relation to work, travel and contact with the family. We carried out a survey to assess our joint radioiodine clinic approach where all patients referred for treatment are assessed jointly by a consultant endocrinol...