Endocrine Abstracts

Case history: A 63-year-old female was admitted to our hospital in January 2022 with neck swelling that had developed over five days with associated dysphagia to fluids. Biochemistry revealed severe hypercalcaemia with a corrected calcium of 3.82 mmol/l (2.20 - 2.60 mmol/l) and PTH of 78.7 pmol/l (1.6 - 6.9 pmol/l), and an associated AKI (creatinine of 174 umol/L from a baseline of 80). Ultrasound initially showed a left-sided 3 x 2 cm nodule suggestive of a large parathyroid ...

The patient is a 45 year old gentleman known case of HIV seropositivity (well-controlled, undetectable viral load) and polycystic kidney disease, who was referred to our Endocrine clinic by the Infectious disease specialists in view of a 4 year history of erectile dysfunction (ED – preceded diagnosis of HIV) and a low testosterone level. During the first consultation, the patient reported occasional lethargy and long term nausea which was attributed to his retroviral trea...

A sixty-four-year old lady with a past medical history of total thyroidectomy for Graves’ disease and atrial fibrillation on amiodarone was referred to the endocrine out-patients in view of hypothyroidism. Since starting amiodarone, the TSH was noted to be elevated at 75 mU/l and the free T4 was 18 pmol/l. The patient complained of non-specific lethargy and was administered levothyroxine 50 mcg daily. Despite this her TSH remained elevated at 147 mU/l with a free T4 of 17...

Pituitary apoplexy arises when haemorrhage and/or infarction occurs within a pituitary tumour. In Malta, the estimated standardised incidence rate (SIR) of apoplexy is 0.15/100,000/yr. ACTH secreting pituitary adenomas have a SIR of 0.17/100,000/year.Case Report: A 46 year-old gentleman with a history of poorly controlled diabetes mellitus was referred following the diagnosis of a pituitary adenoma. He had presented with a 1.5 year history of left third ...

Introduction: Immunotherapy has advanced significantly over the past years. Immune-related adverse events (IRAEs) are various and include endocrinological complications such as Ipilimumab-induced hypophysitis (IIH). The incidence of this cytotoxic T-lymphocyte antigen 4 antibody ranges from 0 to 17%. Patients usually present with symptoms secondary to hormonal insufficiencies.Case report: A 73 year-old lady, known case of metastatic melanoma on immunothe...

Introduction: We hypothesised that children with type 1 diabetes would have more hyperglycaemia following a British as compared to a European breakfast.Methods: Children were asked to take a continental breakfast and a typical British breakfast cereal on separate days. Pre breakfast glucometer readings were documented and then regular readings until lunchtime. The meals were prescribed by a dietitian; they were approximately carbohydrate matched but of d...

Background: The presence of brown adipose tissue (BAT) in adults offers an opportunity to examine inflammatory factors that may affect metabolic function in states of obesity. Gut-derived lipopolysaccharide (LPS), which is elevated in obesity, and initiates the innate immune response in white adipose tissue, has not been fully studied in BAT. The interactions between LPS, TLR4 and ß3-adrenergic receptors in BAT is unknown. ß3-adrenergic receptor ligands as CL 316,243...

A 26 year old man of Angolan descent presented to the endocrine clinic with poorly controlled hypertension (systolic blood pressure >200 mmHg). He had been treated with Amlodipine for almost six years, and more recently the addition of Irbesatan and Indapamide had not led to adequate blood pressure control. His hypertension was diagnosed at age 19 and progressive features of Cushing’s disease had remained unnoticed, with truncal striae, easy bruising, myopathy, puffin...

Aim: Type I Diabetes Mellitus is a chronic metabolic disorder with an incidence of 24,000 children in the UK. NICE has recommended the use of the sensor augmented pump (SAP) in managing short and long term diabetes related complications. Limited literature is available in the paediatric population. SAP is designed to allow continuous glucose monitoring, with real-time adjustment of insulin; making it superior to other pump systems. 0.8% of children suffer from Type I DM in the...

Background: Addison’s disease is characterised by immune mediated destruction of the adrenal glands. This process is widely deemed to be irreversible. We present a case of confirmed Addison’s disease where adrenal function appears to have spontaneously recovered.Case report: A 37-year-old presented in 1997 with classical Addison’s disease: pigmentation, dizziness, weight loss, and nausea. There was no relevant family history. Random cortis...