Endocrine Abstracts

Introduction: GH has been proven to improve lean body mass and muscle strength. We report three cases where growth hormone replacement had a significant effect on gross motor function.Case series: A 15 month old boy was born at 33 weeks of gestation. During infancy, he was noted to have global developmental delay secondary to cerebral atrophy and isolated growth hormone deficiency. He was not able to pull himself to standing position but after commencing...

Background: Metastatic disease is common in bone, with the majority occurring in the spine, pelvis, and long bones such as the femur and humerus. Acrometastasis, a term used to describe malignant spread distal to the elbow and knee, is a pattern less commonly seen. Its rarity often leads to delayed diagnosis; the condition may be confused with more common conditions such as inflammatory arthritis and Charcot neuroarthropathy, the latter especially in particular in patients wit...

Introduction: Total daily insulin required to achieve glycaemic control in type 1 diabetes (T1D) depends on numerous factors. Correlation of insulin requirement to BMI and waist circumference has been variably reported in the literature, whilst that of WHtR has not been studied.Aims: To study the correlation between daily insulin requirement (TDD) and WHtR in a multi-ethnic population.Methods: A cross-sectional study of children (5...

Background: Diabetic ketoacidosis (DKA) in children and young adults carries significant morbidity and mortality relating to complications such as cerebral oedema. Acute kidney injury (AKI) is a rare but potentially fatal complication of DKA. We present three cases of DKA complicated by AKI.Case 1: A 9-year-old girl presented with severe DKA at diagnosis. She was treated with intravenous fluids and insulin as per protocol. She had oliguria and haematuria...

GH therapy has been reported to increase insulin resistance, but overt diabetes is rare. We present a young girl who developed symptoms of diabetes whilst on GH therapy with resolution of symptoms and normalisation of blood glucose profile on reducing the dose of GH.Case report: A 14-year-old girl with background of prematurity, learning difficulty, cerebral palsy, scoliosis, and pan hypopituitarism presented with chest infection, high blood glucose leve...

Objective: A review of the efficacy and safety of radioiodine treatment for Graves’ disease.Methodology: Patients were identified following a search of the nuclear medicine departmental database. Consecutive patients who had radioiodine in 3-year period from January 2009 to December 2011 were included in the audit. Information was obtained from medical notes, blood results and nuclear medicine database. Data was analysed using Microsoft Excel.<p...

The presentation of a patient with an adrenal tumour often causes diagnostic difficulty for the endocrinologist. Adrenal tumours are rare occurrences, particularly when large in size. We present two cases, where large adrenal tumours were found in inpatients on CT scanning and discuss the difficulties which arose in each case when attempting to obtain a definitive diagnosis. Case 1 A 38 year old Bangladeshi woman was being investigated for fevers, sweats and pancytopaenia. She...

Introduction: NICE recommends that pregnant women with pre-existing diabetes should be offered retinal assessment in the 1st and 3rd trimester by digital retinal imaging. Where retinopathy is already present, an additional assessment should be made in the 2nd trimester.Objectives: To assess the feasibility of retinal screening in pregnancy by a community based mobile retinal screening programme (MRSP).Methods: A retrospective audit...

Aim: To evaluate the paediatric specialist diabetes nurse (PDSN) delivered 24 h emergency telephone contact service for families with children and young people with type 1 diabetes within Hull and East Yorkshire Hospitals NHS Trust.Methods: A prospective audit of telephone calls received by the 2 PDSNs over a 15-month period between 1 July 2005 and 30 September 2006 for out of hours advice. All the phone calls were logged into a database and details of t...

Background: Turner syndrome has well recognised cardiovascular complications that appear in up to 40% of the patients and are more common in monosomy X. Left sided obstructive lesions are relatively more frequent and predispose to aortic root dilatation and life threatening aortic dissection. Patients with bicuspid aortic valve, hypertension, coarctation and aortic stenosis are at high risk of aortic dilatation and dissection. Various follow up strategies are in use but there ...