Endocrine Abstracts

Hypercalcaemia (calcium level >2.63 mmol/L) is a common metabolic condition. In spite of its diverse aetiologies, primary hyperparathyroidism and malignancy account for more than 90% of cases, parathyroid adenoma alone contributing to 80–85% of parathyroid related cases. We describe a case of resistant hypercalcemia in a 75-year-old Afro- Caribbean gentleman.He presented with a 2-month history of constipation, loss of appetite & gradual weig...

Background: A number of reports have associated non-alcoholic steatohepatitis (NASH) with aspects of the metabolic syndrome, such as insulin resistance, dyslipidaemia, type 2 diabetes and obesity. NASH can progress to cirrhosis and hepato-cellular carcinoma, as well as acting as a marker for insulin resistance in patients with type 2 diabetes mellitus.Aims: The purpose of this study was to determine the prevalence of abnormal liver function in a populati...

Synthetic levothyroxine (L-Thyroxine) is the treatment of choice for hypothyroidism. It is safe, effective and generally well tolerated. Some patients, however, cannot tolerate L-Thyroxine. There is still some controversy about the effectiveness of combination T4 & T3 therapy. We describe 3 patients who were successfully treated with Armour thyroid (pork extract of T4 & T3) after being intolerant to L-Thyroxine.A 35 yr old lady initially presente...

Background: An increased prevalence of thyroid dysfunction is reported in both type 1 and type 2 diabetes mellitus compared to the normal population. However, the cost-effectiveness or otherwise of screening for thyroid dysfunction in this group of patients is an unresolved question.Aims: The aim of this study was to measure the effectiveness of screening for hypo- and hyperthyroidism, both sub-clinical and overt, in an ethnically diverse population of m...

Aim: To audit clinical outcomes and adherence to prescription recommendations in a diabetes renal clinic.Method: Baseline data was compared to the final clinic visit within a 12 month period, using information from clinic letters and electronic records of patients attending our hospital diabetes renal clinic in 2016 (1st January – 31st December). Patients with at least 1 follow-up within a 12 month period were included.Results...

A 20 year old female with a 3 year history of type 1 diabetes presented to the emergency department unresponsive and was diagnosed with severe diabetic ketoacidosis (DKA). She had no other past medical history and was on a basal bolus regime of insulin only. GCS was 7, pH 6.7, HCO3 3.5 mmol/l, ketones 3+ on urinalysis and blood glucose of 43 mmol/l.She was commenced on fixed rate insulin infusion and IV fluids however also noted to have unequal pupils. S...

Background: A previous short Synacthen test (SST) audit in our hospital (2012) showed 70% of initial SST tests were normal with 9% inappropriate requests. A new pro forma was devised whereby one of four criteria (specific symptoms, medications, previous diagnosis, and physical findings) had to be satisfied to be able to undergo a SST. Additionally, we noticed that a number of patients were probably being over-diagnosed wth adrenal insufficiency (AI) based on a single 30 min co...

Aims: To look at the demographics, biochemistry, treatments used, clinical characteristics associated with radioiodine (RI) treatment (including those with relapse) for thyrotoxicosis in our Endocrine clinic.Methods: Electronic records of all thyrotoxic patients between 2010 and 2012.Results: 144 patients, mean age 56 years (114 females)–106 Graves, 24 toxic adenoma (TA) and 14 multi nodular goitre (MNG). TPO antibody was posi...

Introduction: Pendred syndrome is a rare autosomal recessive condition characterised by sensorineural deafness, goitre and impaired iodine organification. We report a case of a 43-year-old female who presented with hearing impairment, and the development of a multinodular goitre with tracheal compression. Perchlorate testing and genetic studies confirmed a diagnosis of Pendred syndrome. She subsequently underwent partial thyroidectomy and requires lifelong follow-up.<p cla...

The presentation of a patient with an adrenal tumour often causes diagnostic difficulty for the endocrinologist. Adrenal tumours are rare occurrences, particularly when large in size. We present two cases, where large adrenal tumours were found in inpatients on CT scanning and discuss the difficulties which arose in each case when attempting to obtain a definitive diagnosis. Case 1 A 38 year old Bangladeshi woman was being investigated for fevers, sweats and pancytopaenia. She...