Endocrine Abstracts

Neurological complications of thyroid disease are well recognised; however the distinct clinical entity of encephalopathy associated with autoimmune thyroid disease has been only occasionally reported in the paediatric population. We describe a case of Hashimoto’s encephalopathy (HE) in a teenage girl.A 13-year-old girl presented with seizures and prolonged confusion. Baseline blood tests, CSF analysis and CT Brain were essentially normal. She was d...

We describe seven patients with pituitary apoplexy diagnosed between July 2009 and Oct 2010.Presentation and Management: Five patients presented with sudden onset headache, nausea and vomiting. One developed headache while on carbegoline and other presented with fluctuating level of consciousness.All but two patients were inpatients at the hospital when diagnosed and all had MRI scan of pituitary to confirm the diagnosis and any ma...

Introduction: High testosterone level lowers the seizure threshold in patients previously well controlled on medication.Clinical scenario: A 59-year-old male, with a history of complex partial seizure, having 12 years of seizure free period on phenytoin and lamotrigine, presented with short history of vomiting, positional headache, and visual impairment. A diagnosis of pitutary macro adenoma was made following a MRI scan of his head. He underwent a trans...

A 22-year old female diagnosed with thyrotoxicosis with raised free thryroxine (16.8 pmol/l) and suppressed thyroid-stimulating-hormone (TSH<0.03 mIU/l). She was started on Carbimazole 20 mg during end of August 2011. A fortnight later she presented with nausea, vomiting, fever and rigors. Her renal functions were deranged with a creatinine of 704 μmol/l, which worsened over the next 48 h. She subsequently needed renal replacement therapy with haemodialysis. She was c...

Introduction: Meningitis is a recognized complication of the treatment of pituitary adenoma. It is usually considered as a peri-operative problem but does need to be considered as a potential complication at other points in the treatment pathway. We present two patients with meningitis where the link to pituitary pathology was originally unrecognized.Case report:Patient 2: 41 years old lady, presented with a history of nasal drip u...

Introduction: Gastrinoma is a rare neuroendocrine tumor and associated with liver metastasis in 20–40% of cases. We present a rare case report of a patient with stable liver metastasis due to gastrinoma for more than 35 years.Case report: A 49 year old male is currently on our regular clinic follow up for the liver metastasis due to gastrinoma. His past history includes open laparotomy and resection of gastrinoma (Proven histologically) at the age o...

A 74-year-old diabetic lady presented to emergency-department following a collapse due to hypoglycaemia (blood glucose 1.7 mmol/l) and responded dramatically to intravenous–glucose. She had recurrent hypoglycaemic episodes in the last-fortnight, despite discontinuation of her oral hypoglycaemics and no other obvious precipitating factors/toxins like alcohol. She was on prednisolone, 10 mg along with azathioprine, 150 mg, atenolol, 25 mg, and candesartan, 8 mg. She has rhe...

Cerebral salt wasting (CSW) occurs as the result of injury to the central nervous system and is most commonly found among those who have experienced a traumatic brain injury (TBI). Although incidence is varied, it has been reported to be as high as 30% within the patient population presenting to hospital with a TBI. CSW causes hyponatremia with concurrent hypovolemia and increased sodium within urine despite normal renal function. Because of its rare nature, CSW is often misdi...

We are reporting a rare case of ectopic ACTH secreting tumour causing cyclical Cushing’s syndrome. A 63-year-old lady presented in March 2013 with tiredness and bilateral leg swelling and weakness associated with easy bruising. She was admitted to local hospital in April 2013 with worsening proximal myopathy and peripheral oedema. Her midnight cortisol was elevated at 1710 nmol/l. ACTH 610 mU/l, prolactin 476 mU/l, GH 0.21 IU/l, TSH 0.73 mU/l, free T4 of 11.0 p...

Background: Joint British Diabetes Societies (JBDS) have developed guidelines for the treatment and management of diabetic ketoacidosis (DKA) in adults in the United Kingdom (UK). Multiple single center audits are known to assess compliance to guidelines. However, unified data on DKA management across multiple centers is unknown.Aims: To study the precipitating factors and assess for differences in DKA management across UK hospitals.<p class="abstext...