Endocrine Abstracts

Patient information is increasingly well provided, but little is known of patients' actual understanding of their conditions. The aim of this study was to determine the level of knowledge about thyrotoxicosis and its treatment among patients attending the endocrine clinic. Consecutive patients who had received antithyroid drugs were identified from the clinic database and asked to respond to a postal questionnaire. Ethical approval was obtained for the study.Questionnaires...

Adrenal vein sampling (AVS) is used to differentiate between unilateral and bilateral subtypes of primary aldosteronism (PA). However, AVS results may be misinterpreted due to a procedural artefact resulting in low aldosterone levels at the inferior vena cava (IVC), thus making an interpretation of aldosterone to renin ratios difficult. We investigated whether this artefact was due to patients’ being supine before and during AVS, given aldosterone varies with posture, and...

During starvation, ketone bodies acetoacetate and 3-D-hydroxybutyrate are freely soluble energy substrates made by the liver. Their major role is to supply an alternative glucose substrate for the brain under conditions of medium- and long-term energy restriction. The most common cause of pathological ketoacidosis is poorly controlled type 1 diabetic mellitus triggering uncontrolled hyperglycaemia. Other common causes are alcoholic ketoacidosis and fasting ketosis. In non-diab...

Primary aldosteronism (PA) uncommonly presents during pregnancy. Uncontrolled blood pressure may result in adverse maternal and fetal outcomes. We report a case presenting in pregnancy whose management proved particularly challenging, due to variable compliance with therapy, frequent non-attendance at clinic, a subsequent pregnancy and negative imaging.A 24 year old woman presented at 26 weeks gestation with severe pre-eclampsi...

Primary aldosteronism (PA) uncommonly presents during pregnancy. Uncontrolled blood pressure may result in adverse maternal and fetal outcomes. We report a case presenting in pregnancy whose management proved particularly challenging, due to variable compliance with therapy, frequent non-attendance at clinic, a subsequent pregnancy and negative imaging.A 24 year old woman presented at 26 weeks gestation with severe pre-eclampsi...

Introduction: Immobilization hypercalcemia (IH) is more common in children and adolescent due to increased rate of bone turnover and it usually develop 4–6 weeks post trauma but it can begin as early as 2 weeks and as late as six months. We report a patient who developed severer hypercalcemia after sustaining multiple fractures and immobilization.CaseA 24-year-old man was admitted for neurorehabilitation after road traffic acc...

Introduction: Pituitary apoplexy is a rare but life threatening clinical syndrome characterised by acute neuro-ophthalmological features caused by haemorrhage and/or infarction of the pituitary gland. Although many precipitating factors are known, most apoplectic episodes occur spontaneously.Case: A 59-year-old gentleman presented in 2005 with a 12-month history of bitemporal hemianopia. An MR scan revealed a pituitary macroadenoma. When he was reviewed ...

Hypomagnesaemia usually occurs secondary to decreased intestinal absorption or excessive renal excretion. There have been a few reports recently suggesting an association between PPIs and hypomagnesaemia.A 65-year-old lady was referred to the endocrine clinic for investigation of hypomagnesaemia found on routine testing. Serum magnesium was 0.27 mmol/l (normal 0.7–1.0), with corrected serum calcium of 2.0 mmol/l (2.12–2.63), and normal PTH and ...

Introduction: To assess outcome for patients with acromegaly treated at Royal Preston Hospital since 1st of January 2000.Results: Out of 22 patients (12 presenting in the last 2 years) 20 had endoscopic transsphenoidal hypophysectomy and two were managed medically. Headaches, visual disturbance and characteristic morphological features were the main presenting problems. 4 were microadenomas and 18 macroadenomas\. Exact dimensions were only available in 1...

We describe the case of a 22-year-old South Asian male presenting to Endocrine Services with morbid obesity (BMI>50), sexual immaturity and agoraphobia. Born at full term following an uncomplicated pregnancy, he reached all developmental milestones appropriately. His problems began aged 15 after witnessing a murder, with reactive depression and hyperphagia. By the age of 18, he weighed over 140 kg, had poor self-image and suicidal ideation. He was managed initially by seve...