Endocrine Abstracts

Introduction: Bile acid malabsorption (BAM) may be a contributing factor causing diarrhoea in patients with NETs, particularly among those who have undergone previous surgical resection of the terminal ileum and/or right colon or cholecystectomy (Naraev et al 2019). Aim(s): To identify the prevalence of bile acid malabsorption in neuroendocrine tumour patients (NET) at the Queen Elizabeth Hospital Birmingham (QEHB). Materi...

Background: We present a case of a 33 year old female with a background of Turner’s syndrome, adequately managed with growth hormone and oestrogen supplementation, Crohn’s disease, horse shoe kidney and subclinical hypothyroidismCase details: She presented to the emergency team with high-grade fever and right sided hemiplegia 10 days following Astra Zeneca COVID vaccination. Initial blood tests showed mildly raised CRP of 49, thrombocytopenia w...

Incidental adrenal masses is a common finding on abdominal imaging completed for other reasons. Majority of these masses are benign non-functioning adenomas. Investigations are required to ensure they are benign and do not have autonomous hormonal secretion.Aim: We completed an audit to review current practice in the assessment of adrenal incidentaloma at our organisation, a mid-size acute DGH, and compared it with European Society of Endocrinology (ESE)...

Prolactinomas are the most common functional pituitary tumours. Therapy is with dopamine agonists (DA). Cabergoline is frequently used as a first line agent; resistance to therapy is seen to other DA. We present a case of a 32 year old woman who moved to our area in the 1st trimester of pregnancy. She was known to have macroprolactinoma (maximal diameter > 1 cm), impinging on the optic chiasm. She was on cabergoline 0.5 mg once daily, but this was discontinued with no complica...

Over the last few years, there has been an increase in the demand on the National Health Service, with patients presenting to hospital with multiple co-morbidities and increasingly complex needs. The type of endocrine referrals received can vary both in complexity and also between clinicians. The Royal College of physician has published a ‘Referring wisely’ report in June 2017 which aims to improve and streamline the quality of referrals received in each speciality. ...

Introduction: Autosomal dominant hypocalcaemia (ADH) is caused by activating mutations of the calcium sensing receptor (CaSR). Symptomatology ranges from asymptomatic hypocalcaemia to paraesthesia, tetani, laringospasm and, seizures. This is the first report of congenital hyperinsulinism (CHI) in a child with ADH.Case report: A female infant, born at term from non-consanguineous parents, presented on D2 with persistent asymptomatic hypoglycaemia requirin...

Aims: We set out to dispel the commonly held myth that endocrine practice in district general hospitals is dominated by thyroid disease. A local questionnaire revealed trainees felt thyroid disease made-up >50% of DGH referrals.Methods: We reviewed consecutive new patient referrals to our endocrine clinic over a 2-year period. We documented the referral and outcome diagnosis and looked at the distribution of these referrals across the areas of the en...

Introduction: Osteoporosis is a major cause of morbidity in β thalassaemia major patients. Our institution serves one of UK’s largest populations of thalassaemia patients. This study aimed to examine the prevalence of osteopenia and osteoporosis in thalassaemia major patients and identify risk factors for low bone mineral density (BMD).Methods: BMD of lumbar spine and neck of femur were measured using dual-emission X-ray absorptiometry (DEXA). ...

A 69 year old lady with a known history of bipolar disorder presented with confusion, falls, cough and pyrexia. Initial blood test revealed a sodium of 153 mmol/l, potassium 4.7 mmol/l, urea 13.1 mmol/l and creatinine 230 μmol/litre, PH 7.35 and bicarbonate 23. A repeat test few hours later revealed a sodium of 164 mmol/l, serum osmolality 349 mosm/kg and blood glucose 30.3 mmol/l. Urine ketones negative. Her 24 hours urine output went up to 9000 ml and her sodium to 175 ...

Controversy about the optimal dose of 131I in thyrotoxicosis is ongoing. High doses result in higher cure rates, but are associated with elevated risk of hypothyroidism and irradiation exposure. There is no consensus as to the optimum period of thionamide discontinuation prior to treatment, nor to its impact on the success of RAI.We retrospectively analysed 151 clinical records of patients with thyrotoxicosis due to Grave’s disease or tox...