Endocrine Abstracts

Parathyroid hormone-dependent hypercalcaemia is one of the commonest conditions seen in endocrinology clinics. Primary hyperparathyroidism (PHPT) is the usual cause although some cases are due to other conditions including familial hypocalciuric hypercalcaemia (FHH). Making the distinction between PHPT and FHH is important in order to avoid unnecessary parathyroid surgery. Urinary calcium quantification is an integral part of diagnostic investigations. We present the case of a...

Diabetes education plays a vital role especially in newly diagnosed patients to prevent long-term complications and hospital admissions. We present a 68-year old female who was admitted with nausea, vomiting and poor oral intake. She was discharged two weeks ago after having complete pancreatectomy, splenectomy and left adrenalectomy for pancreatic cancer and a left adrenal mass. She did not have past medical history of diabetes and was commenced on basal bolus insulin after s...

Aims and objectives: Variable rate insulin infusion (VRII) is commonly used to achieve normoglycaemia in hospitalised patients. Joint British Diabetes Society (JBDS) produced guidelines on VRIII in 2014 to minimise complications related to inpatient VRII use. Local guidance along with a new VRII chart was introduced in 2017 at the West Suffolk NHS Foundation Trust and staff training provided. We performed an audit to review compliance to national and local VRII guidance.<p...

Cardiac failure is a rare manifestation of thyrotoxicosis in patients without heart disease. However, patients with prior cardiac failure are at high risk of decompensation with thyrotoxicosis. Amiodarone is a widely used antiarrhythmic agent and amiodarone induced thyrotoxicosis (AIT) is not an uncommon complication. We present a case. A 48-year old male with intermittent atrial flutter, dilated cardiomyopathy, myocardial infarction and stroke was referred for severe thyrotox...

Thyroiditis can often lead to initial thyrotoxicosis and it is important to differentiate among the causes as many cases do not require antithyroid drugs. We present a case report of a 48 year old lady who presented with 10 days history of fever, fatigue, myalgia and a painful goitre after returning from a cruise at Caribbean. Examinations showed pyrexia of 38 C but no localising signs of infection. She had a smooth tender goitre and no signs of thyrotoxicosis. Investigations ...

: Primary hyperparathyroidism (PHPT) is a common endocrine condition but is relatively rare in very young people and during pregnancy. The diagnosis in pregnancy poses a unique challenge and is often missed as the symptoms of hypercalcemia mimic those in pregnancy. We present the case of a 20-year old woman who was found to have severe hypercalcemia after she had persistent vomiting in early pregnancy. Biochemistry revealed adjusted calcium of 5.34 mmol/L, parathormone of 103....

A 37-year-old woman presented to ED with abdominal bloating and pain. Ultrasound abdomen showed a viable single intrauterine pregnancy at 24 weeks of gestation. Patient was surprised of the diagnosis as she had longstanding premature ovarian insufficiency (POI). She had stage 3B Hodgkin’s disease (HD) diagnosed at 14 years of age when she had BEAM chemotherapy (Carmustine, Etoposide, Cytarabine and Melphalan) followed by autograft bone marrow transplant for recurrent dise...

A 65-year-old lady who was known to hypothyroidism and was treated with Levothyroxine 100microgram once daily for more than 20 years presented to the endocrine clinic with symptoms and signs of thyrotoxicosis. Apart from Levothyroxine, she was taking over-the-counter multivitamins and Vitamin D. Visual fields were full to confrontation and there was no goitre. Thyrotoxicosis was confirmed biochemically and levothyroxine was stopped. Despite being off Levothyroxine for more tha...

A 49-year-old lady was referred to the endocrine clinic for hypophosphataemia. Apart from tiredness, she had no other symptoms. Past medical history was significant for bronchiectasis, obstructive sleeps apnoea, caudaequina syndrome, migraine and anxiety. She had frequent hospitalisations due to bronchiectasis exacerbations requiring systemic steroids. Usual medications included azithromycin, gabapentin, omeprazole, antacids, laxatives, carbocisteine, fluoxetine, montelukast, ...

Primary hyperparathyroidism (PHPT) is a common endocrine condition. Outside of syndromic presentations, it is relatively rare in young people and during pregnancy. The diagnosis in pregnancy poses a unique challenge and is often missed as the symptoms of hypercalcemia mimic those in pregnancy. We present a case of a 20-year old woman who was found to have severe hypercalcemia after she had persistent vomiting in early pregnancy. Biochemistry showed adjusted calcium of 5.34 mmo...