Endocrine Abstracts

Antipsychotic induced hyperprolactinaemia, mediated by blockade of dopamine D2 receptors, is much more common than prolactinoma in patients receiving antipsychotic medication. We present two cases of the latter.Case 1: A 47-year-old gentleman with depression treated with amitriptyline, fluoxetine and risperidone presented with headaches and a left sided visual field defect. Pituitary MRI showed a 2 cm macroadenoma abutting the optic chiasm. Prolactin was...

We describe a case of pituitary apoplexy in a patient with a known non- functioning macroadenoma. A 57 year old female was incidentally found to have a 20 x 16 mm solid and cystic pituitary mass abutting the optic chiasm on MRI scanning. She had gonadotrophin deficiency on endocrine testing and normal visual fields. Although repeat perimetry 12 months later revealed a mild superior bi-temporal hemianopia, the patient elected not to have surgery.Several m...

The Charcot joint was originally described as tabetic arthopathy and published in 1868. This occurs in approximately 0.2% of people with diabetes and usually involves a prior peripheral neuropathy. Other factors involved in the pathogenesis of this osteoarthropathy are autonomic neuropathy & trauma.A 74-year-old male presented in August 2004 with a subacute history of right foot swelling & discomfort. There was no discreet history of preceding tr...

Non-alcoholic steatohepatitis is part of the spectrum of non-alcoholic fatty liver disease. It is characterised by triglyceride deposition in the liver associated with a lobular hepatitis and elevated circulating aminotransferases. It is associated with insulin resistance and commonly occurs in Type 2 diabetes but is much less widely recognised in patients with Type 1 diabetes.A 29 year old Caucasian male with longstanding Type 1 diabetes presented with ...

The differential diagnosis of post-partum thyrotoxicosis includes Graves' disease and post-partum thyroiditis(PPT). We present two cases which demonstrate the difficulty of interpreting 99mTc-pertechnetate scans in this setting. Case 1 is a 37 year-old lady who presented 5 months post-partum with a month history of palpitations, sweating and heat intolerance. Investigations revealed TSH < 0.01 mU/L, fT3 8.9 pmol/L (NR 10.5-22.7 pmol/L) and fT4 23.4 pmol/L (NR 3.5-6.5 pmol/)...

In August 1999, to reduce pressure on an overcrowded outpatient department and the incidence of undetected early hypothyroidism, we implemented a new protocol for the follow-up of patients undergoing radioiodine treatment for recurrent thyrotoxicosis. Suitable patients are invited to participate in follow-up by telephone. Thyroid function tests are checked at 3, 6, 9 and 12 weeks post-treatment. Patients who become hypothyroid post-treatment (fT4 <14 picomoles per litre) a...

Alemtuzumab is a monoclonal antibody used in the treatment of relapsing-remitting multiple sclerosis (RRMS). Thyroid dysfunction is a common side effect. Alemtuzumab induced Graves’ disease (AIGD) is notable for its fluctuating and unpredictable course. We present the case of two women with RRMS who required total thyroidectomy to manage AIGD and were followed up in our antenatal endocrine clinic during their pregnancy. The first patient is a 31-year-old lady who develope...

Introduction: Graves’ disease (GD), although the most common cause of hyperthyroidism, is relatively uncommon in children, usually manifesting insidiously. Thyroid storm is a well described but rarely seen phenomenon in childhood GD; thyrotoxic crisis is less often discussed and its management can be challenging. We describe a case of GD with thyrotoxic crisis.Case: A 14-year-old female, known to have inadequately c...

We present a case of a young female, who was diagnosed with Graves’ thyrotoxicosis in 2019 with very high TSH Receptor antibody. She had a goitre and mild thyroid ophthalmopathy and was commenced on carbimazole. She was followed up in the Endocrine Clinic and carbimazole was titrated according to the clinical and biochemical picture. Her past medical history included epilepsy, generalised anxiety, and emotionally unstable personality disorder. She had difficult social cir...

Case history: 48-years old man, with no comorbidities, presented to A&E due to global headache of 20 days duration, with associated intermittent vomiting, but no photophobia, cranial nerve impairment, neck pain or visual disturbance. The first head-scan (CT, computed tomography) was unremarkable, hence was discharged with safety advises. One week later, he represented to A&E with similar complaints. On enquiries, he mentioned to be reviewed by an optician 6 months ago,...