Endocrine Abstracts

Introduction: Isolated postprandial hyperinsulinaemic hypoglycaemia (PPHH) in the paediatric age has been exceptionally reported in the literature.Objective: To describe the clinical and biochemical characteristics as well as the management of a cohort of children with isolated PPHH followed at a single tertiary paediatric centre.Subjects and methods: Six children (three males) were collected. The clinical characteristics, diagnosi...

Introduction: Congenital hyperinsulinism (CHI) is a rare genetic disorder that is characterised by persistent hypoglycaemia in infants and children. We are reporting a rare case of diffuse CHI who was also found to have hypopituitarism and several other congenital anomalies. A similar association has not been reported in literature.Case: A female baby was born at 42 weeks gestation with a birth weight of 4.185 kg (1.72 SDS). She suffered shoulder dystoci...

Introduction: We do not fully understand why some hypothyroid patients complain of persistent symptoms despite normalisation of TSH with levothyroxine therapy. Recent evidence in adults suggests that polymorphism in deiodinase2 enzyme could lead to lower level of T3 in some tissues and persistence of symptoms. A combination therapy with T3/T4 may improve symptoms especially psychological well-being, mood and memory in such patients. Combination...

A 48 year-old lady was referred to Endocrinology clinic in November 2016 with symptoms of tiredness and lethargy for two months. Routine bloods were unremarkable, apart from an incidental finding of raised Vitamin D:258 nmol/l(NR: 50–150). She had depression and was otherwise fit & well. She was on Citalopram and combined oral contraceptive pill (Microgynon). She denied any excessive sun exposure. She didn’t drink any milk, only drank orange juice. She took multi...

An 88 year-old male was referred to Endocrine Clinic with abnormal thyroid function test (TFT); free T4:fT4: 36.9pmol/L (NR:11-23) and a normal TSH:2.51mU/L (NR:0.35-5). Atrial Fibrilation was diagnosed recently and was on Apixiban and Bisoprolol. He had history of prostate cancer, hypertension, oesophagitis, cervical spondylosis, splenectomy and CKD3. He felt well apart from slight heartburn. He was a retired motor engineer. He had no family history of thyroid disease and nev...

Background: Congenital hyperinsulinism (CHI) is the commonest cause of persistent hypoglycaemia and is due to the unregulated secretion of insulin from the pancreatic beta-cells. The role of gut hormones and dipeptidyl peptidase-4 (DPP-4) is currently unknown in patients with CHI.Aims: To evaluate the expression pattern of DPP-4 in focal and diffuse CHI.Method: Using intra-operative formalin-fixed paraffin embedded (FFPE) pancreati...

Case: A 46-years-old anaesthetist presented with 2 weeks history of general malaise, sore throat, and fever. Symptoms started while on holiday. A diagnosis of subacute thyroiditis was made overseas based on presentation and suppressed TSH level. He was started on betamethasone 4mg and ibuprofen for 2 weeks with rapid symptomatic improvement. He felt well enough to travel back to UK. He then presented to our hospital with recurrent symptoms as above.Inves...

Insulinomas are rare neuroendocrine tumours that classically present with a combination of symptomatic hypoglycaemia, low serum glucose values and resolution of symptoms post glucose ingestion.We describe a 65-year-old lady who repeatedly presented over several years with recurrent infections, predominantly of the urinary tract, nausea and diarrhoea, necessitating frequent hospital admissions. Despite extensive investigations, no clear cause for her symp...

Introduction: Choline PET-CT is a recognised modality for imaging prostate cancer; both for initial staging and restaging. It is, however, a non specific tracer and is also positive in numerous other conditions such as inflammatory processes and other malignancies.Method: We present a case of a 60 year old patient with a PSA of 9 ng/ml and a firm abnormal right prostate lobe. Prostate MRI demonstrated a lesion in the apex of the prostate but no associate...

Imaging in paragangliomas can be challenging as they arise from a number of locations including the adrenals, abdomen, pelvic and thoracic sites of chromaffin sympathetic tissue. They can also arise in the head and neck at sites of parasympathetic tissue. They are considered within the group of heterogenous neuroendocrine tumours. In addition to manifesting at multiple sites, they can metastasise, have variable expression of catecholamines and can be a manifestation of heredit...