Endocrine Abstracts

Section 1: Case history An 86 year old female presented to hospital after being found on the floor and had profound lower limb oedema. She was treated for a urinary tract infection and possible heart failure. On examination she had significant hirsutism and bruised skin. She had a past medical history of BCC removal and primary hyperparathyroidism. Her ECOG performance status was 1–2. There was a family history of pancreatic cancer (father) and pancreatic neuroendocrine tumour...

Introduction: Osteopenia and osteoporosis develop with aging in thalassemia patients despite clinical treatment therapy has improved. Bisphosphonates, which are potent inhibitors of osteoclastic bone resorption, have been recently used to correct the bone abnormality in thalassemia with encouraging results. Bisphosphonates are a class of drugs that prevent the loss of bone mass, used to treat osteoporosis and similar diseases. They are the most commonly prescribed drugs used t...

Introduction: T regulatory lymphocytes (Tregs) are defined as CD4+CD25high T lymphocytes and are thought to regulate immune tolerance. The Foxp3 protein level in Tregs is proportional to CD25 protein surface expression and regulatory function, but inversely proportional to IL-7R (CD127) level, the receptor for the growth and survival of T cells. We investigated possible differences in Tregs between newly diagnosed type 1 diabetes (DM1) patients and contro...

Objective: The Fas/Fas ligand (FasL) apoptotic pathway is activated in patients with autoimmune thyroid disease (AITD). It is believed that Fas and FasL expression in intrathyroidal T lymphocytes and thyrocytes is regulated in a manner resulting in thyroid cell apoptosis in Hashimoto’s thyroiditis (HT) or lymphocyte apoptosis in Graves’ disease (GD). The hypothesis that Fas and FasL may be differentially expressed on peripheral lymphocytes in patients with HT and GD ...

We report a 44 year old lady with a history of weight loss, anxiety and ‘prominent eyes’. She was clinically and biochemically thyrotoxic (FT4: 158.1 pmol/L [12–22], FT3:56.5 pmol/L [2.8–7.], TSH:<0.08 mU/L [0.30–4.30]). She was commenced on carbimazole and propranolol. Failure to attend regular clinic appointments or comply with drug therapy over the next few years resulted in huge swings of her thyroid status from severe thyrotoxicosis to profoun...

A 56 year old lady presented with a short history of neuromuscular weakness. She was dehydrated but conscious, alert and oriented and without focal neurology. Her initial blood results revealed a corrected calcium 5.02 mmol/L, phosphate 1.49 mmol/L, alkaline phosphatase 152 iu/L, urea 31.8 mmol/L and creatinine 266 micromol/L.Intravenous rehydration with normal saline and 90 mg of pamidronate was given. She received 4 litres of normal saline daily and her renal functions norma...

Introduction: Metabolic syndrome (MetS) is a cluster of interconnected factors that directly increase the risk of DM2 and CVD. Stevia rebaudiana (a low calorie natural sweetener) and its compounds are known for anti-hyperglycemic, anti-inflammatory, anti-oxidant, anti-hypertensive effects.Methods: Thirty-eight patients (age 47.3±10.3 years) (nmales=14, nfemales=24) with MetS (NCEP/ATPIII criteria) wer...

Introduction: Autoimmune thyrotoxicosis (AT) affects 2-5% of the Western population. Despite current NICE guidelines recommending radioiodine as first-line treatment for AT, practical considerations such as licensing often prevent this. Typically, anti-thyroid medication (carbimazole or propylthiouracil) is initially offered. Patients are usually counselled that the remission rate following a 12-18 month course of anti-thyroid medication is approximately 50%.<p class="abst...

A 29 year-old nursing student, was incidentally detected to have high serum calcium 3.43 mmol/l (2.2-2.6) whilst being treated for community acquired pneumonia. She had no symptoms of hypercalcaemia. Her uncle had been operated for primary hyperparathyroidism (PHPT) although only limited details were available. PTH of 28 pmol/l (1.6-7.2) confirmed the diagnosis of PHPT. She had vitamin D deficiency, normal liver and renal function. She was offered parathyroidectomy and preoper...

A 58-year-old gentleman who was otherwise well presented with urinary symptoms. As part of his investigation for this he underwent a CT scan which showed an incidental 6 cm right adrenal mass compressing the inferior vena cava and superior pole of the right kidney with a 6-mm pulmonary nodule. He was subsequently found to have a raised urinary normetanephrine of 48.81 (normal range 0–3.3) suggestive that the mass was a pheochromocytoma. Retrospectively he reported episode...