Endocrine Abstracts

Background: Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is an autosomal recessive inherited disorder resulting in the inability to breakdown medium-chain fatty acids to provide energy during periods of low-calorie intake and hypoglycaemia (infections, fasting, vomiting). Without urgent treatment, the accumulation of toxic fatty acids leads to encephalopathy and sudden death.Pregnant females with Type 1 diabetes requ...

Introduction: Mild hypercalcaemia can occur in patients with Graves’ disease. Postulated mechanisms include increased bone resorption and mobilisation of calcium from the bones in response to increased interleukin-6 and catecholamine levels. The coexistence of primary hyperparathyroidism and Graves’ disease is rare. Hypercalcaemia with suppressed or unsuppressed parathyroid hormone levels should prompt a search for non-parathyroid or parathyroid causes, respectively....

Introduction: Lithium associated hyperparathyroidism (LAH) resulting in hypercalcaemia is a known problem. Treatment options are limited in frail elderly patients with multiple co-morbidities, in whom parathyroid surgery could be dangerous. Cinacalcet, a calcimimetic agent can be an alternative option. We report a case of an elderly lady on Lithium, who was initiated on Cinacalcet for hypercalcaemia and has had to continue the Lithium for her bipolar affective disorder.<p ...

Introduction: Limbic encephalitis is characterised by seizures, changes in personality and memory impairment. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) associated with autoimmune limbic encephalitis is rare. We present an interesting case.Case: A 57-year-old gentleman presented with seizures and a cardiac arrest. He had a past history of excess alcohol intake and had been taking excess alcohol prior to this event. Physical examinat...

Background: The effect of weight loss on hypothalamic function is complex and not fully understood. There is interplay between neuropeptides (leptin, ghrelin) and hypothalamus with the postulated aim of energy conservation and prevention of pregnancy during unfavourable conditions. We present a memorable case.Case: A 35-yr-old lady presented with secondary amenorrhoea of 17 years duration. She attained menarche at age 13. At age 16 her periods became sca...

Introduction: Klinefelter’s syndrome (KFS) is associated with an increased risk of certain malignancies; including leukemia, breast cancer and mediastinal germ cell tumours. Testicular tumours are uncommon. Epidermoid cysts are benign tumours of hair-growing areas. Testicular epidermoid cysts are very rare and account for 1–2% of all testicular tumours. We report a rare case of bilateral epidermoid cysts in a patient with Klinefelter’s syndrome.<p class="abs...

Introduction: Radioactive iodine (RAI) has been used to treat hyperthyroidism for over 70 years. Some centres use a fixed dose regimen while others use a calculated dose regimen. Cure rates range between 80% and 100%, with some patients requiring two or more doses. We use the fixed-dose regimen at our centre. We therefore evaluated our cure rates after a single dose of RAI to treat hyperthyroidism.Methods: We reviewed th...

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...