Endocrine Abstracts

Background: In clinical practice, occasional hypothyroid patients require more than the expected dose of levothyroxine. This could be due to compliance issues, excess body weight, drug interference or malabsorption. The Grampian Automated Follow-Up Register (GAFUR) currently monitors around 17 500 hypothyroid patients on levothyroxine; 36 (0.6%) patients take more than 250 μg of levothyroxine daily.Methods: A questionnaire was sent to these patients...

IntroductionAntithyroid drugs are widely used in the therapy of hyperthyroidism. This review (update of Cochrane review: Antithyroid drug regimen for treating Graves' hyperthyroidism. In: The Cochrane Library, Issue 4, 2003; with 4 additional trials) assesses the effects of dose, regimen and duration of antithyroid drug therapy for Graves' hyperthyroidism.MethodsThe Cochrane Controlled Trials Register, MEDLIN...

While iodine deficiency goitre is common worldwide, it is rarely described in the U.K. Vegan diet is the only real way for this deficiency to occur in the U.K. A MEDLINE search from 1966 revealed 1 reported case (Shaikh et al. Transient neonatal hypothyroidism due to a maternal vegan diet; Journal of Pediatric Endocrinology & Metabolism Jan 2003). We have identified 3 cases, which we will describe here.Case 1A 21-year-ol...

Background: Primary hyperparathyroidism is the commonest cause of hypercalcemia. Current guidelines advise to rule out familial hypocalciuric hypercalcemia (FHH) when evaluating hypercalcemia. It is widely considered that FHH is associated with low urine calcium creatinine clearance ratio (CCCR). However, low CCCR can also occur in Primary hyperparathyroidism.Case: A 30 years lady presented with hypercalcemia and high parathyroid hormone (PTH). She had a...

Background: Hypothalamus pituitary adrenal axis (HPA) dysfunction is associated with serious morbidity and mortality. Its symptoms can be non-specific. Objective diagnosis depends on clinical suspicion and confirmed on assessment of early morning cortisol or dynamic assessment of cortisol secretion. The cosyntropin or short synacthen test (SST) has emerged as the most common test to assess the HPA. The insulin stimulation test (IST) is the traditional ‘gold standard’...

Background: Myasthenia gravis and thyroid disease can sometimes create diagnostic confusion because the two may have similar clinical features and may also co-exist in the same individual.Case: A 68 years male, was seen in the Neurology clinic with drooping of his left eyelid, first noticed 8 months prior, worse in the evenings. There were no other complaints. He had history of type2 diabetes, and Graves’ disease. On examination, he appeared to have...

Introduction: There are many causes of central diabetes insipidus including trauma, drugs, metastatic tumor, lymphoma, leukemia, inflammation, virus infection and gene mutation. They’re very few cases in England reported as pituitary involvement of NHL [no-Hodgkin lymphoma] Approximately about 31 cases were reported in the literature as NHL of the pituitary as in Pub medicine, however in these series of cases the most common presentation among them was ce...

Case history: A frail 79 years old lady with dementia presented with frequent falls since 2 years ago. Neurologist’s assessment had attributed her fainting episodes to migraine. She later was found to have biochemically evident recurrent hypoglycaemia requiring multiple admissions and eventually continuous glucose infusion to maintain euglycemia.Investigations: The severe spontaneous hypoglycaemia in this non-diabetic lady prompted investigations. T...

Case: A 61 year old female, presented to ENT in July ’17 with 6 month history of left sided neck swelling, gradually increasing in size over the last 1 month prior to presentation. She complained of tenderness over the swelling and pain and discomfort around her left shoulder. She denied any problems with her voice, breathing or swallowing. Her past medical history consisted of recurrent UTI’s, renal stones and medullary sponge kidney. She smokes 15 cigarettes per da...

Aims: Endocrine Society (ES) acromegaly guidelines (2014) addressed complication screening. Uncontrolled acromegaly is associated with elevated cardiovascular mortality due to risk factors including hypertension (HT), diabetes mellitus (DM), obstructive sleep apnoea (OSA), and with an increased risk of colorectal cancer and polyps among other types of neoplasias. We audited our clinical practice with regards to acromegaly complication screening.Methods: ...