Endocrine Abstracts

Background: Adrenal lymphomas are rare and often present with hypoadrenalism in the context of bilateral adrenal masses. We report a patient with unilateral adrenal mass and hypoadrenalism at presentation before evolving rapidly to bilateral masses proven to be a large B cell lymphoma. We discuss mechanisms of hypoadrenalism in adrenal lymphoma.Case history: A 79 year gentleman with no signifanct past medical history admitted with a 6 week history of bei...

Pseudohypoglycemia has been reported in patients with Raynaud’s phenomenon, peripheral vascular disease and shock and may result from increased glucose extraction by the tissues because of low capillary flow and increased glucose transit time. We present a frail and comorbid 76-year-old lady with a long standing history of Rheumatoid arthritis/systemic sclerosis/systemic lupus erythematosis overlap syndrome complicated by Raynaud’s phenomenon. She was on long-term st...

Riedel thyroiditis, an uncommon form of chronic thyroiditis in which the thyroid gland is replaced by fibrous tissue, is difficult to differentiate from the fibrous variant of Hashimoto thyroiditis or lymphoma. We report a patient illustrating this. A 54 year old lady with a long standing goitre and 3 year history of stable hypothyroidism was referred for progressive thyroid gland enlargement over several months, dysphagia and an increasing thyroxine requirement. Clinically, s...

Background: Hypoglycaemia is rare in people without diabetes. Certain medications are known to cause hypoglycaemia in non-diabetic patients.Case details: A 65-year-old man with background congestive cardiac failure, previous pulmonary TB (1997), bronchiectasis and pulmonary fibrosis (long-term oxygen therapy) was admitted for exacerbation of bronchiectasis. He completed a course of antibiotics and steroid treatment. While awaiting discharge, he had two e...

Adrenal incidentalomas are increasingly recognised with the use of abdominal imaging with prevalence ranging from 0.35-0.45%. The vast majority of these are benign adrenocortical adenomas. Increasingly, subclinical hypercortisolism is recognised in such cases.We describe a case of a 34-year-old asymptomatic primigravida with chance recognition of an adrenal mass during an obstetric ultrasound. Biochemical testing revealed consistently normal urinary catecholamine and eleva...

Background: Graves’ disease and Hashimoto’s thyroiditis are the most common autoimmune thyroid conditions. Hyperthyroidism following hypothyroidism is a rare phenomenon. Hypothyroidism was once thought to be a permanent state requiring lifelong replacement therapy but we have noted that there are increasing numbers of cases which are against this postulation. We would like to report 3 cases initially diagnosed with hypothyroidism and referred to us following developm...

Peripartum hyponatraemia is an under-recognised complication of labour and poses a risk to both mother and baby. It is typically caused by water intoxication for physiological reasons and population health trends around water intake. We have recent experience of managing 2 patients with severe symptomatic hyponatraemia. Both patients had increased their oral intake of fluid during labour as well as receiving intravenous fluids. Dilutional hyponatraemia was found to be the unde...

Case history: We present the case of a 64 year old gentleman diagnosed with hypoparathyroidism following presentation with acute hypocalcemia post thoracic aneurysm surgery for aortic dissection. The etiology was felt to be a complication of thoracic surgery with possible disruption of blood supply to the parathyroid glands.Deeper investigation at a subsequent review revealed persistent hypocalcaemia predating surgery by over 10 years. This was on the ba...

Objectives: Transient thyroid hypofunction during the initial 3 months following radioiodine (RAI) therapy is well recognised with a reported incidence of 10–15%. There are no clear diagnostic criteria, often leading to management uncertainty, inappropriate diagnosis of ‘cure’ and institution of life-long thyroxine therapy. The aim of our audit was to assess the incidence and identify predictors for transient euthyroidism or hypothyroidism following administrati...

Aim: The aim of our study was to explore the possibility of using a district-wide laboratory database as a governance tool to ensure the optimum management of patients with biochemical hyperthyroidism.Patients and methods: A complete list of patients on whom TFT were requested over a 3-month period was obtained and patients with unequivocal hyperthyroidism were identified. General practitioners (GP) of patients not referred to the specialist endocrine te...