Endocrine Abstracts

A 27 year old male patient with severe cardiomyopathy secondary to Epirubicin chemotherapy for rhabdomyosarcoma in infancy was noted to be hypercalcaemic during the course of admission for severe inotrope dependant congestive cardiac failure. Biochemical investigations confirmed a diagnosis of primary hyperparathyroidism (corrected Calcium 3.10 mmol/l, PTH 22 pmol/l, Vitamin D 77 nmol/l).His brother had undergone trans-sphenoidal pituitary surgery for ac...

We present a case of a 52-year-old man with a past medical history of primary hypothyroidism on treatment, presenting with elevated TSH levels, suggesting inadequate thyroxine (T4) replacement. The patient was managed with 200 μg of T4 for 14 years with no compliance issues. TSH levels failed to normalise despite increasing the dose of T4. In addition to elevated TSH levels the patient noted progressive leg swelling and associated shortnes...

Introduction: Hyponatraemia, defined as serum sodium <135 mmol/l is one of the commonest electrolyte abnormalities seen in patients admitted to acute hospitals and is associated with increased morbidity and mortality. Impact of this condition is not adequately measured in critically ill patients admitted to intensive care unit. The aim of this observational study was to assess the incidence and outcomes of patients admitted to intensive care unit (ICU) in a UK based settin...

Background: Management of ACTH-dependent Cushing's syndrome (ACTH-CS) remains a challenge. In the past 2 decades open bilateral adrenalectomy, associated high morbidity and long post-operative in-patient stay, has usually been reserved for cases of failed transsphenoidal surgery (TpS) and radiotherapy (RT), or where the source of ACTH is not found. Laparoscopic adrenalectomy is a significant advance with low morbidity and mortality.Aim: To assess the eff...

Case history: A 28 year old male presented following his first generalised tonic clonic seizure in the context of a headache with mild photophobia, nausea and vomiting. He was haemodynamically stable, euvolaemic and had no focal neurological deficit, but was mildly disoriented. He had reported cannabis and MDMA use 8 days prior to his presentation. The patient was profoundly hyponatraemic with a serum sodium of 108.Investigations: Serum osmolality was 22...

Introduction: Heparin is extensively used amongst different medical and surgical specialities for prophylaxis and treatment of venous thromboembolism and suspected coronary syndromes. Hyperkalaemia is known to occur as an effect of heparin treatment through its action on the renin-angiotensin system, especially when used at treatment doses. Hyperkalaemia is a serious electrolyte disturbance, which may precipitate potentially fatal cardiac arrhythmias. We describe a case of a p...

Introduction: Hyonatraemia, defined as serum sodium <135 mmol/l is the commonest electrolyte abnormalities and is associated with increased morbidity and mortality.Aim: To determine the prevalence of mild, moderate, and severe Hyponatraemia in the hospitalised patients and estimate mortality between these three groups and compared to Normonatraemia.Methods: This is a retrospective audit in patients admitted to hospital from Jul...

Background: Many Endocrinologists believe that preoperative localisation/lateralization in patients undergoing initial neck exploration for primary hyperparathyroidism is unimportant because of high cure rate in the hands of experienced surgeons. Tcm-MIBI imaging has a sensitivity of 70 to 95% in localizing parathyroid tumors. Ultrasonography has lower sensitivity but is noninvasive and relatively cheap. Unilateral surgical exploration has potential benefits including reduced ...

Introduction: Development and progression of cancers is multifactorial encompassing several mechanisms that aid its proliferation. One of the hallmarks of cancer progression is inhibition of the immune system. Cancer cells can activate different immune checkpoint are pathways that harbour inhibitory or stimulatory mechanisms that enabled self-tolerance and assist with immune response. Through activation of immune checkpoint pathways cancers can suppress immune response against...

Background and aims: Over 200 000 international adoptions by US families occurred between 1999–2010. Prior studies suggest that the effects of institutionalized care on growth and development may not be fully reversible. The exact mechanisms through which early life stress affect biobehavioral outcomes have yet to be determined, but environmental influences could regulate both biobehavoral outcomes through an effect on the hypothalamic-pituitary-adrenal (HPA) axis.<p ...