Endocrine Abstracts

Case report: A 29-year old Caucasian male was referred to our Endocrinology Outpatient Clinic following a recent admission after an episode of collapse when he was noted to have abnormal thyroid function tests: fT4 32.6 (7.5–21.1) pmol/l, TSH 6.41 (0.34–5.6) mU/l. These were repeated and again showed elevated fT4 26.9 pmol/l and normal TSH 2.29 mU/l. He reported some tremor of both hands but denied palpitations. He was clinically euthyroid but p...

Patients with diabetes are prone to peripheral vascular disease. We present the case of an 81 year old female, current smoker who presented to her general practitioner with a 3 day history of ankle oedema for which she received furosemide. She had a background of right above knee amputation due to peripheral vascular disease and essential thrombocythaemia. Five days after commencing furosemide, she developed increased lethargy and confusion. On arrival to hospital, her venous ...

Background: This project endeavoured to improve the quality of endocrinology teaching to clinical medical students through the use of a new multi-stage process.Methods: We created a co-ordinated block containing 4-h teaching sessions (4×1 h) in which eight students in their first clinical year presented answers to questions based on clinical endocrinology cases they had seen and selected. The process started with identification of cases in the out-p...

Background: Cushing’s syndrome derived from paraneoplastic ectopic ACTH production can present in dramatic fashion. We describe such a case that presented with severe hypokalaemia, involving significant diagnostic and management challenges.The case: A 66-year-old female was referred acutely to hospital by her GP after feeling weak and lethargic. She had profound hypokalaemia of 1.5 mmol/l (3.5–5.3) with normal renal function and had been normok...

Background: The global uptake of bariatric surgery in men, despite high prevalence of morbid obesity and associated co-morbidities, is significantly lower compared to women. It is unclear if this is due to a perception of poorer outcomes in men. AimsTo compare weight loss and metabolic outcomes in men versus women after bariatric surgery.Design and methods: We performed a retrospective, observational cohort analysis of 80 men matched to 80 women for base...

Background/aims: The transcription factor neurogenin 3 (NGN3) is required for pancreatic islet cell specification from multipotent progenitor cells; yet we have limited understanding of the downstream genetic program it directly initiates. A 3 Mb centromeric region on chromosome 20p contains a number of genes activated downstream of NGN3 including INSM1 and NKX2.2. We proposed that NGN3 alters the expression of other genes within this region as poten...

Aim: To evaluate the current service provisions and provide action plan for improvement within the YAE service.Methods: A friends and family questionnaire given to all patients attending the YAE service from October 2018 – January 2019. Survey questions included: whether they thought this was a good clinic for friends and family to be looked after in, what we did well and what we could do better. For YA patients transferring from children’s s...

Denosumab is a monoclonal antibody used in the treatment of osteoporosis to prevent bony injuries by increasing bone density. It does so by binding to RANK-L, which is then unable to activate RANK, thereby preventing osteoclast maturation and viability. Although rare, the effect of denosumab can interfere with the body’s calcium homeostasis and lead to a hypocalcemic state. We present a case where a post-menopausal female developed severe, symptomatic hypocalcemia from a...

This 23 years old man was noted incidentally to have bilateral adrenal calcification on CT scan of his abdomen for chronic abdominal pain. He had normal growth and milestones with no neonatal events. Aged 10 years he was admitted briefly to a high dependency unit with circulatory shock and hyperthermia, with isolation of Streptococcus mitis from blood culture. One year later he was noted to have bilateral adrenal calcification on abdominal XR, and a short Synacthen (250 μ...

Objective: To assess age- and growth-dependent gene expression in children and correlate this with biological pathways.Methods: We conducted a gene expression meta-analysis on datasets from normal children curated from the NCBI Gene Expression Omnibus (GEO). Four datasets were combined to form a group of 87 individuals ranging from 0.2 to 29.3 years of age (average 7.7±6.9yr). Analysis of gene expression data was performed using hierarchical cluster...