Endocrine Abstracts

Background: There are over 650 liver transplants performed in the UK each year and about 5000 throughout Europe. After transplantation patients suffer from bone loss due to multiple factors. We present a unique case of severe Vitamin D deficiency resulting in life threatening hypocalcaemia following liver transplantation.Case: A 65-year-old Indian lady underwent an uncomplicated liver transplant, for hepatocellular carcinoma related to Hepatitis C. Pre a...

Aim: To ascertain epidemiology and outcomes in Maltese patients with acromegaly.Method: Retrospective case record study of acromegalic patients diagnosed between 1979 and 2008.Results: Forty-seven patients were recruited (25 females and 22 males). The prevalence of acromegaly in the Maltese population was 11.4 per 100 000 population. Of 77% had a macroadenoma (53% extrasellar, 24% intrasellar). Of 15% had a microadenoma. Two tumour...

Aim: To evaluate epidemiology, clinical presentation, treatment and subsequent outcomes in Maltese patients with NFPA.Methods: Retrospective case record study of all patients with NFPA.Results: Forty-eight patients with a NFPA were identified with an estimated prevalence of 1.16 per 10 000 population. 58% of these were male and the mean age at presentation was 50.6 years (S.D. 13.4 years) (men – 52.5 years; wome...

A 45-year-old man was found wandering in the streets by the Ambulance Service. He complained of productive cough with haemoptysis. On examination he was cachectic with clubbing, and he was confused (abbreviated mental test score 1/10). Chest XR showed left hilar and perihilar air space shadowing. He was treated for a community acquired pneumonia. A CT scan of the head showed a mass lesion in the pituitary fossa, confirmed on an MRI scan.Assessment of his...

Both brown (BAT) and white (WAT) adipose tissue have neuroanatomically well characterized sympathetic innervation (with activation initiating lipid mobilization), but little evidence to support the presence of a (putatively counter-regulatory) parasympathetic input.Parasympathetic actions are mediated through muscarinic acetylcholine receptors (mAChR). The mouse 3T3-L1 (white fat-derived) cell line expresses M1, M3 and M4 mAChR during differen...

Familial isolated growth hormone deficiency is exceedingly rare. We present two siblings of non-consanguineous parents with this syndrome and describe their response to growth hormone therapy. We have also carried out a mutational analysis of their GH1 and GHRH-R genes.A mutation scan of the entire coding region and flanking intronic sequences of GH-1 and GHRH-R was undertaken in both index cases and parents. GH1 and GHRH-R mu...

We report the case of a 59-year-old male who presented complaining of several weeks of tiredness, poor appetite and dizziness on standing. He had been treated with flucloxacillin by his GP for otitis externa one week earlier.In 1982, he was diagnosed with nasopharyngeal carcinoma in Hong Kong, which was treated by radical dissection and radiotherapy.On examination, his standing and lying blood pressure were 150/100 and 110/90 respe...

Background: Hashimoto’s encephalopathy is a rare steroid-responsive condition associated with high antithyroid antibody titres. We report a case of autoimmune thyroiditis presenting with status epileptics.Case: A 36-year-old non-epileptic Caucasian lady presented as an emergency with uncontrolled generalised seizures requiring sedation, short-term ventilation and maintenance sodium valproate therapy. Further enquiry revealed a 3–4 week history ...

A 32-year-old man was referred for investigation of spastic paraparesis. There was a history of two seizures in the past. Of note was that his mother had previously been investigated for a mild spastic paraparesis, and had been diagnosed with idiopathic generalised epilepsy. MRI scan of the cervical and thoracic cord appeared normal but the MRI brain scan showed diffuse high signal intensity areas in the occipital white matter of both cerebral hemispheres. An EEG suggested idi...

A 68-year-old lady was admitted with constipation, epigastric pain, vomiting, occasional coffee ground emesis and melena. She had no chest pain, osmotic symptoms or weight changes. Past medical history was significant for peptic ulcer disease and she was not taking any medications apart from over the counter cod liver oil. She did not have diabetes or cardiovascular risk factors. Her sister had type 1 diabetes. Examination was remarkable for dehydration, mild tachycardia and m...