Endocrine Abstracts

Introduction: Hashitoxicosis is the rare case of autoimmune thyroid disease. While transforming from Graves’ disease to spontaneous hypothyroid is well known, development of hyperthyroidism following hypothyroidism is a rare phenomenon which can pose a challenge in management. We report here a case of Hashitoxicosis managed with "Block and Replace Therapy" to maintain her euthyroid while waiting for definitive therapy.Case Report: A 30-year-...

Incidental adrenal masses is a common finding on abdominal imaging completed for other reasons. Majority of these masses are benign non-functioning adenomas. Investigations are required to ensure they are benign and do not have autonomous hormonal secretion.Aim: We completed an audit to review current practice in the assessment of adrenal incidentaloma at our organisation, a mid-size acute DGH, and compared it with European Society of Endocrinology (ESE)...

Background: The treatment of choice for primary hyperparathyroidism (PHPT) is surgical parathyroidectomy. Cinacalcet is the first calcimimetic approved by European Medicines Agency (EMA) in 2008 for use in patients with PHPT who are not fit for surgery or refuse surgery. British National Formulary (BNF) recommends it for hypercalcaemia in PHPT where parathyroidectomy is inappropriate. The main aim of treatment with cinacalcet is to keep calcium levels at safe levels.<p cla...

Introduction: Isolated vomiting is a rare often forgotten presentation of Graves’s disease and can lead to delayed diagnosis. Multiple case reports quote vomiting in thyrotoxicosis co-presenting with Addisonian crisis, diabetic ketoacidosis or with abnormal liver function and jaundice. Another common association is hyperemesis gravidarum. Vomiting in paraneoplastic hyperthyroidism occurs through a similar mechanism of beta-HCG secretion, mainly related to germ-line tumour...

Background: Heterozygous loss of function glucokinase mutations causes MODY with fasting hyperglycaemia (>5.5 mmol/l). We report a 2 year girl with a glucokinase mutation who presented unusually with stress induced hyperglycaemia and normal fasting blood glucose levels.Case report: She presented with wheeze and was started on Salbutamol. Her blood glucose rose to 16 mmol/l with ketonuria. The hyperglycaemia was disproportionate to the severity of the...

In recent years, there is increased interest in using maggot debridement therapy (MDT) for ulcer treatment. MDT has shown beneficial effects on ulcers’ rate of healing, need for surgical intervention, and number of antibiotic-free days. In this retrospective study, we looked into the effects of MDT on the length of inpatient stay and need for surgical intervention.Data were collected from 33 randomly selected patients admitted into hospital with pri...

We present the case of a 50-year-old lady who initially presented to the endocrine department at Royal Bolton Hospital in 2011 with symptoms of tiredness and lethargy following hysterectomy and bilateral salpingo-oophorectomy in 2003. Hormone replacement therapy was not commenced in view of a strong family history of breast cancer. There is a family history of both autoimmune hypothyroidism and hyperthyroidism. Thyroid function tests were normal, with a positive thyroid peroxi...

Introduction: Hyperthyroidism is a common endocrine disorder in pregnancy, with potentially significant foeto-maternal consequences.Description of the case: 25 year old lady with auto-immune hyperthyroidism (TRAb>400) was treated with Propranolol and Carbimazole and referred to the Endocrine clinic. She was started on Block and replace therapy. She was soon moved over to Carbimazole as she was contemplating pregnancy. She became hypothyroid in 3 mont...

Background: Neonatal diabetes can present from birth to 6 months of age. This can often be confused with sepsis as there is considerable overlap of symptoms in this age group as illustrated below. We recommend an initial check of blood glucose concentrations in all sick infants who present to accident and emergency.Case report: A 7-week-old, born to nonconsanguineous parents presented with a temperature of 38.6 °C and a 1 day history of poor feedin...

Background: Congenital hyperinsulinism (CHI) is one of the commonest causes of recurrent hypoglycaemia due to excess production of insulin in infancy and results in neurological impairment in a third to a half of patients. The treatment of CHI is often complex and complicated by side effects; the medium-term effects of such treatment are not known.Aim: To describe five year clinical outcomes in a cohort of infants with CHI.Methods:...