Endocrine Abstracts

A 74 year old lady was admitted with an agitated depression. She had been taking Lorazepam and Olanzapine throughout the preceding 6 months. Escitalopram had been introduced 2 months prior to admission and the dose was escalated 3 weeks prior to presentation. The dose of Olanzapine was doubled at the same time.She was treated with sotalol for atrial fibrillation and she had documented labile hypertension (BP range 77/57–250/118). She had fluctuating...

Single gene defects causing severe insulin resistance have been elucidated either by directed screening of candidate genes (INSR, AKT2, PPARG) or by detailed linkage mapping in large pedigrees (BSCL2, AGPAT2, LMNA), and study of patients harbouring these known defects continues to yield important insights into insulin’s action in health and disease. However a large proportion of the genetic defects leading to severe insulin resistance in slim subjects remains undiscovered...

Hypothalamic-pituitary (HP) dysfunction is common in children treated with cranial radiotherapy (RT) for brain tumours but there is little known about the risk of HP dysfunction in adults treated with RT for primary non-pituitary brain tumours.We aimed to investigate the frequency of HP dysfunction in adults after RT for primary brain tumours which are distant from the HP region.We studied 56 adult patients who received external be...

IntroductionPrimary Aldosteronism (PA) is the commonest secondary cause of hypertension. Mainstay therapy, adrenalectomy resects both hypersecreting and adjacent normal tissue. It is therefore only suitable for patients with unilateral disease (40% cases), whom are surgical candidates. Thermal therapy presents a plausible minimally invasive therapy, to target and disrupt hypersecreting aldosterone producing adenomas (APA), while also preserving adjacent ...

Background: Childhood growth monitoring aims to identify growth failure and detect underlying pathology. According to UK guidance, height <-2.7 standard deviation score (SDS) (<0.4th percentile) is used as the referral threshold. Additional referral criteria include height deficit (HSDS-target height SDS) <-2.0 and height velocity (HV) SDS <-1.3. Lack of routine HV and mid-parental height calculation, combined with stricter cut-offs compared to other European c...

Background: Congenital Hyperinsulinism (CHI) is characterised by dysregulated and excess secretion of insulin leading to severe hypoglycaemia. Monitoring of glucose levels is essential in this condition as prolonged hypoglycaemia can cause life-threatening complications such as permanent neurological impairment. Interstitial glucose monitoring by continuous glucose monitoring (CGM) devices can identify nocturnal hypoglycaemia retrospectively through data analysis. Analysis can...

Introduction: Hyponatraemia is the commonest electrolyte disturbance affecting patients in and out of hospital. Streamlining and improving the investigation of hyponatraemia will quicken diagnosis, improve patient outcomes and prevent deterioration and unnecessary stay in hospital. We aimed to audit the assessment of patients with hyponatraemia against our existing guidelines (Hyponatraemia – An Investigator’s Checklist).<p class="abst...

Introduction: Radioiodine is used for the treatment of Thyrotoxicosis when medical treatment (anti-thyroid drugs) has failed or cannot be tolerated and surgical treatment is not an option. Our previous audit in 2011 demonstrated substantial adherence to the Royal College of Physicians (RCP) guidelines for Radioiodine treatment, but one patient was lost to follow-up. It was recommended that we improve our re-call system. We aimed to re-audit our service.<p ...

Introduction: Single-electrolyte derangement is a common biochemical finding. Multiple-electrolytes derangement is less common and require multiple and simultaneous corrective therapies. We present a patient who had multiple admissions with multiple-electrolytes derangement, which after further evaluation required a single therapeutic intervention.Case: A 26-year-old lady had eight admissions over three years with abdominal pain and vomiting. During each...

Introduction: Hyponatraemia is the commonest electrolyte disturbance affecting patients in and out of hospital. Streamlining and improving the investigation of hyponatraemia will quicken diagnosis, improve patient outcomes and prevent deterioration and unnecessary stay in hospital. We aimed to audit the assessment of patients with hyponatraemia against our existing guidelines (Hyponatraemia – An Investigator’s Checklist).<p class="abst...