Endocrine Abstracts

A 31 year old female presented to the Endocrine day ward due to headache and dizziness in 2015. She had a background of childhood acute lymphoblastic leukaemia diagnosed at age 7 treated with chemotherapy. She had a cerebral recurrence at age 10 and underwent cerebral radiotherapy, further chemotherapy and subsequently total body irradiation and bone marrow transplant. Following this treatment she was diagnosed with panhypopituitarism and required hormone replacement therapy w...

In 2009 a 39 year old gentleman presented to the Endocrine clinic with symptoms, signs and biochemistry consistent with severe glucocorticoid excess (urinary free cortisol level was significantly raised at >1380mol/24 hours, normal up to 124; early morning cortisol levels varying between 760nmol/land 1225nmol/lwith failure of suppression on a low dose dexamethasone suppression test). An ACTH level taken at this time was 43ng/l. He underwent an MRI pituitary gland which sho...

A 30-year-old lady was initially seen in our clinic with a slight elevated corrected calcium with an elevated parathyroid hormone in March 2021. The elevated calcium [2.58mmol/l(NR: 2.10-2.55)] was first noted in 2018 when she had investigations for easy bruising, fatigue, breathlessness, and weight loss. The symptoms settled on their own and her calcium levels were monitored routinely. She was referred to our clinic when the corrected calcium had increased to 2.69mmol/lwith a...

A 43-year-old Bangladeshi lady was seen in the endocrinology clinic after recent admission to hospital with vomiting and headaches. Her past medical history included Type 2 diabetes, hypertension, ischaemic heart disease and goitre. During admission, a diagnosis of euglycaemic diabetic ketoacidosis (DKA) was made (pH 7.31, bicarbonate 18.3, glucose 7.8 and ketones 6.1) secondary to SGLT-2 inhibitor. This was managed with a fixed rate insulin infusion, intravenous fluid hydrati...

Section 1: Case history : A 49 year old South Asian gentleman was admitted to the emergency department after monitoring blood tests showed hypercalcaemia (corrected calcium of 3.67mmol/l) and acute kidney injury. He had a recent admission with a new diagnosis of miliary tuberculosis and superadded bacterial infection, complicated by a long and complex ITU admission after initiation of treatment. He was discharged home on colecalciferol 4000 units daily in addition to his anti-...

Evidence suggests that empowering patients of chronic illness with self-management skills improves the outcomes. European countries with high emphasis on diabetes self-management education report significantly better clinical outcomes. In PREM survey, few service users expressed the desire to know the results of their annual review blood results. We used this as a trigger for a project to inform service users about their annual care processes completion status. We describe the...

Hyponatremia, defined as a serum sodium concentration below 135 mmol/l is acknowledged to be the most common electrolyte disturbance within hospital environment. Hyponatremia, specifically severe hyponatremia, is associated with an increase in morbidity and mortality.Aim: Audit aim was to evaluate the diagnosis, investigation, and management of hyponatremia in our district general hospital. This is a retrospective audit using lab data and clinical notes....

We present a case of a 52-year-old man with a past medical history of primary hypothyroidism on treatment, presenting with elevated TSH levels, suggesting inadequate thyroxine (T4) replacement. The patient was managed with 200 μg of T4 for 14 years with no compliance issues. TSH levels failed to normalise despite increasing the dose of T4. In addition to elevated TSH levels the patient noted progressive leg swelling and associated shortnes...

Introduction: Hypoglycaemia is a common paediatric medical emergency, hence prompt treatment with appropriate investigations of causes is essential.Aims: (1) Review current practice of investigating hypoglycaemia in children; (2) Improve awareness of local guidelines; (3) Overcome practical hurdles when investigating hypoglycaemiaMethods: • Retrospective audit of investigation of hypoglycaemic patients over a year using clinic...

Introduction: Poorly managed transition could adversely impact upon adjustment to diabetes and potentially result in non-adherence to treatment, loss to follow-up and worsening of health-related outcomes. In our DGH, approximately 20 Young Person (YP) with T1DM get transferred to YP Clinic every year. YP between 17–19 years of age attend a joint clinic before the transfer. The YP Clinic provides a continuity of diabetes care up to the age of 25 years.<p class="abstext...