Endocrine Abstracts

59 year old woman with relapsing remitting multiple sclerosis (MS), not under Neurology follow-up was privately consulting a nutritionist based in Ireland and following the Coimbra protocol1 since December 2016. This included colecalciferol (1000-170000 IU/ day), vitamin B-complex and trace elements. Dose adjustments were advised during weekly skype consultations based on blood tests (via General Practitioner) and symptoms.<p class="abstex...

Case: We report a rare case of a primary cardiac paraganglioma. A 49-year-old male was found to have elevated3-methoxytyramine (3-MT) levels with normal metanephrines, having undergone a screening test following discovery of SDHB gene mutation, after his 10-year-old niece developed a phaeochromocytoma.The patient demonstrated no hypertension and did not bear signs of catecholamine excess, but on direct questioning...

Introduction: Tolosa Hunt Syndrome (THS) is a steroid-responsive idiopathic inflammatory condition affecting cavernous sinus and/or orbital apex causing painful ophthalmoplegia. We present a rare case of THS resulting in hypopituitarism.Case: 45-year-old female presented with 10-day history of headache, periorbital pain and diplopia. Past medical history included bipolar disorder and bilateral below knee amputation ...

A 21 year old Asian woman presented with relapse of Neuromyelitis Optica (NMO) spectrum disorder, diagnosed aged 16. She had headache, dizziness, right hand weakness and severe hyponatraemia (serum sodium [Na+] 116 [135–145]). Emesis, dominant in previous relapses, was absent – she was euvolaemic. Serum (Seosm) and urine (Uosm) osmolalities were 250 and 468 mosm/kg respectively, thyroid function ...

Introduction: Hypoparathyroidism may be an isolated or a component of a complex syndrome. Although genetic disorders are not the most common cause, molecular analyses have identified a growing number of genes that when defective result in impaired formation of the parathyroid glands, disordered synthesis or secretion of parathyroid hormone.Case presentation: We are reporting a 37-year-old gentleman, who is the first adult case diagnosed at our University...

Introduction: Phaeochromocytoma affects <1:100000 people per year. Wilms tumour (WT) affects almost 1:10000 children each year. Both tumours are associated with somatic genetic alterations: Phaeochromocytoma (RET, VHL, NF1, SDHA, SDHAF2, SDHB, SDHC, SDCD, TMEM127 and MAX); WT (WT1, 11p13, 11p15, tp53, NSD1, KDM3B, BRCA2). Both tumours affecting the same person have only been reported twice in the literature.Case Report: We report a lady who, at the a...

Patients with Adrenal Insufficiency are potentially at risk of life threatening events if during intercurrent illness they do not take adequate glucocorticoid replacement. The National Institute for Health and Care Excellence Clinical Knowledge Summaries for this patient group recommend that they should: know how to self inject intramuscular hydrocortisone in an emergency; how to adjust their steroid replacement in response to illness; understand the importance of medical iden...

Background: Electronic endocrinology advice and Guidance (e-Endo A&G) via NHS e-Referral Service was introduced at University Hospitals of Leicester NHS Trust (UHL) in March 2017 to address General Practitioners’ (GP) non-urgent endocrinology clinical concerns. Primary aims of the service, was to prevent inappropriate outpatient visits, avoid acute admissions and reducing length of time in resolution of queries.Objectives: To retrospectively eva...

Background: The benefits of patient education in women with polycystic ovary syndrome (PCOS) are known but a cost effective way to offer the education to these patients need to be assessed. As part of a quality improvement project in an outpatient setting we tested the idea of incorporating group education for women with PCOS in their routine care process. We tested two different methods.Methods: 1. January-June 2017: Ad hoc open patient invitation<p...

Introduction: Endocrinopathy is frequently seen in systemic amyloidosis and commonly involves thyroid and gonads. We report a case of primary adrenal failure secondary to systemic light chain amyloidosis (AL), involving kidney, liver, spleen, gut, nerves and tongue.Case: A 42-year-old Somalian lady presented with 2-year history of lethargy, febrile episodes and 21 kg weight loss. Investigations showed increase in serum lambda light chain 103 mg/l (5.7&#1...