Endocrine Abstracts

This 42-year-old male presented with a six-month history of general lethargy and mood changes. He had experienced weakness & difficulty climbing stairs; weight loss; ankle swelling and increased frequency of micturition. There was no significant past medical history.Initial investigations revealed Na+ 144mmol/L (135-145);K+ 2.3mmol/L(3.5-5.2); U 8.8mmol/L (2.6-6.7); Cr 75μmol/L (60-125); TCO2 41mmol/L (21-31); Fasting glucose 7.4mmol/L; TSH 0.21mU...

This 42-year-old male presented with a six-month history of general lethargy and mood changes. He had experienced weakness & difficulty climbing stairs; weight loss; ankle swelling and increased frequency of micturition. There was no significant past medical history.Initial investigations revealed Na+ 144mmol/L (135-145);K+ 2.3mmol/L(3.5-5.2); U 8.8mmol/L (2.6-6.7); Cr 75μmol/L (60-125); TCO2 41mmol/L (21-31); Fasting glucose 7.4mmol/L; TSH 0.21mU...

A 36 year old lady presented with a 6 month history of amenorrhoea & increasing fatigue. There was no background of headaches or visual disturbance. She denied thyroid related symptoms. Examination revealed her to be both pale and fatigued however there were no other significant findings. Investigations revealed: random cortisol 56 nmol/l; prolactin 1698mU/l (0-480); LH 0.3U/l; FSH 2.9U/l; fT4 <5pmol/l (10-24); TSH 21.92mU/l (0.4-4.0); IGF1 12.5nmol/l (10-24) An insulin...

Introduction: Vitamin D deficiency is increasingly being recognized as a metabolic disorder in temperate climates with various bone, cardiovascular and systemic manifestations. However topical, it is important to exclude tumour induced osteogenic osteomalacia as a possible aetiology in severe vitamin D deficiency when other risk factors (vegetarian diet, ethnicity, etc.) are absent. Early diagnosis of malignant tumors could be life saving and their resection may make this vita...

Introduction: A 59-year-old gentleman with longstanding poorly controlled type 2 diabetes mellitus, obesity, hypertension, obstructive sleep apnoea, depression and type 2 respiratory failure was seen in diabetes review clinic and noted to have truncal obesity, moon facies and wasting of the proximal muscles.Investigations: Urinary free cortisol was 782 nmol/24 h (NR <200). Midnight cortisol was 595 and 532 nmol/l on consecutive days. After low dose d...

We report a case of a 20-year-old male with a clinical profile of Gorlin-Goltz syndrome with delayed puberty. This 20-year-old man had learning disablitiy, macrocephaly and multiple jaw cysts. His other clinical features included agenesis of the carpus callosum, obesity and multiple cutaneous lesions suggestive of angiolipomata. His pubertal development was delayed although a LHRH test done at the age of 16 showed a normal response. Radiological features included macrocephaly,...

This 55-year-old gentleman presented to endocrine clinic following an episode of septicaemic shock complicating benign prostatic surgery one year previously. He subsequently developed symptoms of lethargy, palpitations, lightheadedness, peripheral weakness and loss of libido, which had developed after this episode. Routine biochemistry and ambulatory electrocardiography measurements were normal.Endocrine testing revealed:: - Undetectable gonadotrophins (...

Armour thyroid (Armour) is unlicensed in the UK for the treatment of hypothyroidism. It is natural porcine-derived thyroid replacement with 1 grain containing 38 mcg levothyroxine (T4) and 9 mcg L-triiodothyronine (T3), and unspecified amounts of T1, T2 and calcitonin. We have used Armour as a third line agent in selected patients who have not responded adequately to T4 monotherapy, and combination T4/T3 therapy since 2003.Aim: To assess c...

A 64-year-old man presented with mild biochemical hyperthyroidism – TSH <0.01 mU/l (NR 0.35–4.90), FT4 19.4 pmol/l (NR 9–19) in 2005. He was treated by his general practitioner with a 9 months course of carbimazole. Six months later, TSH became suppressed (0.05 mU/l) but with a normal fT4 (17 pmol/l). He was referred to a ‘One-Stop’ Thyroid Clinic and was seen there 3 months later. Thyroid isotope scan showed a toxic multinodular goitre. He was tre...

Current UK guidelines for thyroid nodules advise a thyroid ultrasound (ThyUSS) with U-Classification with or without Fine Needle Aspiration (FNA) with Thy-Classification to determine malignancy risk. We report four cases where thyroid carcinoma was diagnosed histologically following reassuring cytology and radiological examination. This is a case of 28-year-old female who presented with neck swelling. ThyUSS showed an enlarged left thyroid with cystic and solid components; FNA...