Endocrine Abstracts

Selective Parathyroid Venous Sampling in Patients with Complicated Primary HyperparathyroidismCM Ogilvie, PL Brown, M Matson, R Carpenter, WM Drake, PJ Jenkins, SL Chew, JP MonsonCentre for Endocrinology and Departments of Surgery and Radiology, St Bartholomew's Hospital, QMUL, London EC1A 7BEThe role of pre-operative localisation of abnormal parathyroid glands remains controversial but is particularly releva...

THE SENSITIVITY OF 123I-MIBG IN THE DETECTION OF HISTOLOGICALLY CONFIRMED CATECHOLAMINE-PRODUCING TUMOURS.M Ismail, R Foley, WM Drake, AB Grossman, PJ Jenkins, SL Chew, GMBesser, R Reznek, K Britton, JP MonsonDepartments of Endocrinology, Nuclear Medicine and Radiology, StBartholomew's Hospital (QMUL), London EC1A 7BERadionuclide imaging is widely used for the loc...

We present the case of a 72-year-old gentleman was admitted to our hospital with atrial fibrillation secondary to severe hypokalemia of 1.8 mmol/l, but normal serum sodium and creatinine. He had prostate cancer with extensive liver and bone metastases. After potassium supplementation 180–200 mmol/day for 10 days serum levels persisted between 2.3 and 2.9 mmol/l. During this short period he developed early Cushingoid features, jaundice and diabetes. After overnignt dexamet...

Familial Dysalbuminaemic Hyperthyroxinaemia (FDH) is characterised by mutant albumin with increased affinity for thyroxine, and to a lesser extent triiodothyronine, giving falsely elevated fT4 and fT3 levels in standard assays. This may lead to inappropriate management of euthyroid patients, and complicate diagnosis and management of thyroid disease in patients with coexistent FDH. We report a case of Graves’ thyrotoxicosis complicated by underlying FDH. A 41-year-old wom...

Introduction: We describe a novel case of familial congenital aniridia in a Caucasian woman with associated insulin requiring diabetes mellitus. This human combination has been described in Asian families in association with a heterozygous Paired Box 6 (PAX6) mutation (1) with subsequent evidence supporting that the mutation in this transcription factor causes decreased Proconvertase 1/3 function in the pancreas and a high proinsulin to insulin ratio (2). Our case does not hav...

BACKGROUND Recent evidence has suggested that minor degrees of thyroid dysfunction are associated with adverse outcomes and this argues for tight control of thyroid hormone replacement. Thyroxine (T4) tablets are available in 25, 50 and 100 microgram strengths in the UK but some patients require doses which cannot be obtained with these strengths. We have examined data from a thyroid register to determine the proportion of patients whose mean daily T4 dose cannot be achieved w...

We describe an interesting case of a man who poses a significant ongoing management challenge. He presented with mild biochemical evidence of T3 thyrotoxicosis (FT3, 8.2, FT4 13.6, TSH 0.02). Carbimazole 20 mg was started and despite increasing dosage, he deteriorated significantly. He was concordant with medication. His TBII and thyroid auto-antibodies were negative. A Tc uptake scan showed reduced uptake. Prednisolone was added, thinking that he may have thyroiditis. Despite...

Background: Polycystic ovary syndrome (PCOS) is characterised by anovulation and insulin resistance but the effects on reproductive outcomes are unclear.Objectives: To determine the impact of PCOS upon fertility, pregnancy complications and delivery method.Methods: Data were extracted from the Clinical Practice Research Datalink. Patients with a diagnosis of PCOS (2000–2012) were matched to controls (1:2) by age (±1 year)...

Introduction: Acute left ventricular failure is rarely caused by phaeochromocytoma. The rarity and severity of this presentation may result in delayed investigation and incorrect management.Case Report: A 22 year old woman was admitted with headache, vomiting, back pain and malaise. She was initially treated for suspected septic shock with intravenous antibiotics and fluids. Within 24 hours of admission, she rapidly deteriorated and developed pulmonary o...

Hereditary nephrogenic diabetes (di/di) in mice results from a failure of vasopressin (VP)action caused by overactive renal cAMP phosphodiesterase activity. The adult animals pass large amounts of dilute (100 mOsm per kg) urine and have hyperosmotic plasma (40 mOsm per kg greater than wild-type). Their osmotic status is therefore similar to that in Brattleboro rats in which both VP and oxytocin (OT) neurons are hyperactive and the neural lobe is depleted of both OT and VP. The...