Endocrine Abstracts

A 35 year old Asian man presented to the emergency department on several occasions with episodes of severe muscle weakness, affecting his arms and legs, to the point he was unable to walk or stand. He was found to be hypokalaemic on both occasions, at 2.3mmol/l and 3.0mmol/l respectively, and his weakness gradually improved with potassium replacement. He gave a history of two years of intermittent weakness and stiffness of the limbs which typically occurred at night or after l...

We are presenting a common case of diagnostic dilemma with hypercalcemia.This 66 year female patient was referred to Endocrine clinic with hypercalcemia. She was asymptomatic with blood tests showing C.Calcium of 2.73 mmol/l. This was followed by investigations to rule out primary or tertiary hyperparathyroidism.Blood tests revealed high PTH of 12.2 pmol/l with low 25OH Vitamin D of 37 nmol/l, suggesting a diagnosis of tertiary hyp...

Introduction: Neurofibromatosis Type 1 (NF1) is an autosomal dominant inherited disorder, which increases the risk of developing both benign and malignant tumours. A Swedish study conducted by Zöller et al in 1997, suggested that up to 25% of these tumours are neuroendocrine in origin, of which phaeochromocytomas were the commonest with a prevalence of 0.1–6%. The association between NF1 and primary hyperparathyroidism is described in the literature but clinically ra...

Case History-A 74 year old female patient presented to the emergency department following a witnessed seizure and profound hypoglycaemia (BM 1.1 mmol/l) with an initial GCS of 7/15. Collateral history described 4 days’ feeling unwell with reduced oral intake and multiple recent ‘vacant episodes’. An urgent CT head was unremarkable. Past medical history included hypothyroidism of several years’ duration on T4 50 mcg [3 months’ prior to admission, TSH wa...

Aims: Develop and validate a LC–MS/MS assay for the measurement of serum 17-hydroxyprogesterone (17-OHP) and to establish reference ranges for levels observed in the follicular and luteal phases of the menstrual cycle.Method: Serum samples (200 μl) underwent liquid extraction using di-ethyl ether (1 ml). A deuterated internal standard was used. 20 μl extract was injected onto a Waters Atlantis C18 column using a Waters 2795 Alliance HPLC s...

Myxoedema coma or severe decompensated hypothyroidism is rare but has high mortality; appropriate early recognition and treatment is essential. We present a case of severe hypothyroidism with multi organ failure. A 58-year-old lady with several months’ history of loss of appetite, tiredness and hair loss presented with progressive lethargy, sleepiness and abdominal distension for 1 week. On admission she was very drowsy, had a doughy dry skin and facial puffiness. Large a...

Introduction: Obesity is an independent risk factor of coronary artery disease, and it has also been shown to be associated with increased survival in some instances such as myocardial infarction – dubbed the ‘Obesity Paradox’. However, there is a paucity of studies identifying the type of myocardial infarction – non-ST-segment elevation MI (NSTEMI) or ST-segment MI (STEMI) – that may be differentially prevalant according to BMI (body mass index) ...

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...

Background: Increasing numbers of children and adults are surviving cancer and living with the consequences of their disease or its treatment. The commonest long term consequences observed following childhood cancer are endocrine and there is a growing body of evidence indicating that adults treated for malignant disease are also at risk of endocrine dysfunction.Aim: To determine the involvement of Endocrinologists in the management of cancer survivors a...

Several enzymes are expressed in adipose tissue which catalyse interconversion of steroids, generating oestrogens (aromatase), androgens (5α-reductase 1), and glucocorticoids (11β-HSD1). These steroids may activate local receptors which influence body fat accumulation and distribution, or be secreted to exert endocrine effects. Several mouse models (e.g. aromatase and 11β-HSD1 knockout mice and studies with 11β-HSD1 inhibitors) illustrate the potential impo...