Endocrine Abstracts

I have now lived with my Addison’s (adrenal failure) for 7 years. I have achieved a lot during that time and am grateful for the medical care I have received. I was in my 30s when diagnosed, whilst living and working in Germany, after having felt ill for a few months. I was diagnosed with hypothyroidism at the same time, and started on 50 mcg thyroxine and 20 mg hydrocortisone, with doses of 10 mg - 5 mg - 5 mg. When I was given my first dose of hydrocortisone, it was ama...

Background: Adrenal insufficiency is a common complication of pituitary surgery. We screen for hypoadrenalism with a day 4 morning cortisol. If < 400 nmol/l the patient is prescribed steroid replacement. Patients have a follow up short synacthen test at 6 weeks to assess the hypothalamic-pituitary-adrenal axis. We wanted to ensure the threshold of 400 nmol/l stopped patients with/or developing hypoadrenalism being discharged without glucocorticoid replacement. We also want...

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Introduction: Although type 1 diabetes is the most common type of diabetes in children, with the steady increase in type 2 and rare forms of diabetes, it may be sometimes difficult to ascertain the type of diabetes at the time of presentation. Some children present with a combination of features and do not fit into one of the classical types of diabetes. The rapid progress in the molecular genetics has helped to identify the specific diagnosis for these rare forms of diabetes....

Introduction: Neonatal thyroid screening commenced in the UK in 1981. The TSH cut off point cut off point has changed from 80 mu/l to 25 mu/l over the period for early detection and referral. From April 2006 in the West midland this has dropped to 20 mu/l as upper level and 10 mu/l as lower level.Method: Retrospective audit was undertaken in our hospital on babies referred with an abnormal Guthrie test for a period of 13 years from April 1996 to April 20...

Background: The National Paediatric Diabetes Audit has identified inequalities in diabetes care. Children and young people (CYP) with Type 1 Diabetes Mellitus (T1DM) from both ethnic minority backgrounds and deprived areas are more likely to have reduced access to diabetes technologies and a higher HbA1c. In our service there was an inconsistent approach to the initiation of Continuous Glucose Monitoring (CGM) and use of insulin pumps. The introduction of a st...

Insulin oedema is uncommon and poorly understood. It has been reported mainly in the adult literature. We present one of the youngest cases reported in the literature.A previously obese 9-year-old boy gradually lost weight over 18-month period and experienced polyuria and polydipsia for several months. He presented in diabetic ketoacidosis (blood glucose 24 mmol/l, pH 7.13, bicarbonate 6.6 mmol/l, potassium 3.13 mmol/l, urinary ketones 3+) which resp...

Introduction: Glargine is a recombinant human insulin analogue, used in the treatment of diabetes mellitus. Although widely used, information regarding the altered time-effect profile of glargine taken in overdose is scarce. We describe a case which highlights this phenomenon.Case report: An 82-year-old female was found by her neighbour, 18 h after attempting suicide by injecting herself with 600 units of glargine at multiple sites. Her capillary blood g...

A 70-year-old woman presented with low back pain. A diagnosis of discitis (L4-L5) was made and the patient was started on IV flucloxacillin 1 g every 6 h and fusidic acid. The back pain was improving and the serum electrolytes were all within normal range with potassium level at 4.4 mmol/l (normal: 4.0–5.5) and magnesium at 0.68 mmol/l (normal: 0.7–1.1). However two weeks after starting the IV flucloxacillin, the patient’s electrolytes showed a persistent hypoka...

Neuroendocrine tumours are rare, with an incidence of 8/100,000 in the UK. They result from excessive proliferation of neuroendocrine cells and are classified based on their site of origin, differentiation and clinical syndrome. Giant cell arteritis (GCA), a systemic vasculitis of unknown aetiology, rarely appears as a paraneoplastic syndrome. It is histologically characterised by granulomatous infiltrates with multinucleated giant cells at the intima media junction. The relat...