Endocrine Abstracts

Case history: A 17 year old previously healthy male presented to his local emergency department with a generalised tonic seizure associated with severe hypertension (systolic blood pressure 240 mmHg) and tachycardia. He was intubated and admitted to the Intensive Care Unit. Antimicrobials to cover meningoencephalitis were commenced and his hypertension was managed with intravenous labetalol. He was extubated the following day. He had experienced headaches on a monthly basis fo...

Background: Childhood obesity is associated with multitude of co-morbidities. Idiopathic intracranial hypertension (IIH) is one of the less common co-morbidities in children and young people. Severe migraine has been postulated as a further association. We report our experience of using topiramate for managing obesity associated IIH and severe persistent migraine.Cases: Case One: A 12 year old boy was referred with morbid obesity, systemic hypertension a...

Introduction: Pituitary disorders are associated with increased mortality and morbidity. Data on the prevalence of pituitary disorders is scarce. Formal routine coding of diagnoses in outpatient endocrine practice lags behind medical coding of inpatients. Standardised coding could improve our understanding of disease burden and highlight areas of increasing need within our services.Objective: Automatically extract and assign SNOMED codes for endocrine di...

Background: Studies suggest that glucocorticoid hypersecretion alongside primary hyperaldosteronism (PA) is common and may contribute to the adverse metabolic phenotype. Adrenal crisis post-surgery for PA is rare.Aim: To determine the prevalence of cortisol co-secretion in PA in patients at Imperial College London NHS Trust, Hammersmith Hospital (a tertiary referral centre for adrenal tumours).Methods: Am...

Background: Studies suggest that glucocorticoid hypersecretion alongside primary hyperaldosteronism (PA) is common and may contribute to the adverse metabolic phenotype. Adrenal crisis post-surgery for PA is rare.Aim: To determine the prevalence of cortisol co-secretion in PA in patients at Imperial College London NHS Trust, Hammersmith Hospital (a tertiary referral centre for adrenal tumours).Methods: Am...

Case history: 36 years old, 14 weeks pregnant lady was referred to endocrinology department by GP urgently with corrected Calcium CCa of 2.97 mmol/l and normal parathyroid hormone (PTH). Her symptoms were urinary frequency and nausea. She had 3 previous miscarriages and 2 normal births. She was on folic acid and vitamin D supplements. There was family history of type 2 diabetes and B12 deficiency. Her 6 family members had normal calcium levels.Investigat...

Case history: PD is a 57-year-old female teacher who presented to her GP in October 2017 with lethargy, dyspnoea and anaemia. Bone marrow biopsy followed by a CT scan of her chest and abdomen confirmed lobular breast cancer with peritoneal and bone metastases (ER+/HER2−). The patient also had an MRI scan of her head to assess for intracranial metastatic disease which was negative at the start of December 2017. She was commenced on letrozole, palbociclib and denosumab. A ...

Case history: A 30-year old female presented with a 10-month history of enlarging neck mass, fatigue and weight gain. Assessment by her GP found her to have a large smooth goitre and biochemical hypothyroidism. The patient had a history of intestinal failure secondary to mitochondrial disorder. As a result of intestinal failure she was entirely dependent on parenteral nutrition and was intolerant of any oral intake, with venting of her stomach to reduce pain. She was referred ...

Phaeochromocytomas are life-threatening catecholamine-producing tumours of the adrenal medulla. Our understanding of their pathogenesis is incomplete, with limited ability to predict malignant potential and disappointing treatment results in disseminated disease. Phaeochromocytomas occur in the inherited cancer syndrome von Hippel-Lindau (VHL). One function of VHL protein is in the formation and maintenance of primary cilia. These are microtubule-based organelles that protrude...

A 46-year-old male was brought to the hospital by his uncle as he was found to be acutely confused and agitated ‘talking rubbish’ and giggling inappropriately. Last time he was seen well was 3 days ago. He was a cyclist who lived alone and his past medical history included Graves’ disease and AF. He was on propranolol, carbimazole and warfarin. A month ago he needed admission to a different hospital after falling off his bike. At that time he also developed conf...