Endocrine Abstracts

A 38-year-old man presented on the acute medical take with a week’s history of sore throat, dysphagia, neck swelling, and fever. One month prior he had suffered a respiratory tract infection, which resolved without antibiotics. He had no notable past medical and family history. He was a non-smoker and drank 15 units of alcohol per week. On examination he looked well, was afebrile, sweaty and flushed; chest was clear, heart sounds were normal, regular pulse (110 bpm) and B...

A 31-year-old man presented with a two month history of sweating, right-sided abdominal pain and supraclavicular swelling. CT scanning showed widespread lymphadenopathy with multiple retroperitoneal lymph nodes. Biopsy of a left supraclavicular node resulted in a diagnosis of metastatic paraganglioma. Raised urinary catecholamine as well as urinary metanephrine levels further confirmed the diagnosis.A normocytic anaemia requiring repeated blood transfusi...

Background: Vitamin D deficiency is a common feature of primary hyperparathyroidism (PHP). However, replacement of vitamin D is not routinely performed in clinical practice, due to concerns about its safety. Furthermore, it is not clear whether vitamin D deficiency worsens the biochemical derangements observed in patients with PHP.Aim: To determine the relationship between 25(OH) vitamin D status and biochemical markers in patients with PHP.<p class=...

A 65-year-old lady presented to the emergency department with breathlessness due to an exacerbation of chronic airways disease. Her past medical history included laryngeal carcinoma treated with total-laryngectomy, thyroidectomy and adjuvant radiotherapy in 2003. She remained on stable post-operative replacement doses of 125mcg of levothyroxine and 1mcg 1-Alfacalcidol/1g Sandocal TDS for hypoparathyroidism for several years. Three days prior to her admission, strontium ranelat...

A 31 year old man presented with a two month history of sweating, right-sided abdominal pain and supraclavicular swelling. CT scanning showed widespread lymphadenopathy with multiple retroperitoneal lymph nodes. Biopsy of a left supraclavicular node resulted in a diagnosis of metastatic paraganglioma. Raised urinary catecholamine as well as urinary metanephrine levels further confirmed the diagnosis. A normocytic anaemia requiring repeated blood transfusions was believed to be...

Lithium increases retention of Iodine-131 in the thyroid gland and inhibits thyroid hormone release following radioactive iodine (RAI) administration. However, outcomes of studies of the effects of lithium on the efficacy of RAI are conflicting. The aim of this study was to assess whether adjuvant lithium increases the efficacy of RAI treatment in hyperthyroidism. A retrospective cohort study was performed of 204 hyperthyroid patients (163 Graves’ disease, 26 toxic multin...

A 31-year gentleman presented with a four day history of anxiety and confusion. Over several months, he had noticed red eyes and a ‘stomach-ache’. A collateral history revealed a previous episode of confusion and concern about excessive alcohol intake. He denied any current medication. On examination, he had bilateral conjunctivitis. Investigations demonstrated severe hypercalcaemia of 3.54 mmol/l (NR 2.15–2.6 mmol/l). He was treated with intravenous fluids and ...

Background: Patients with acromegaly require lifetime monitoring due to the excess mortality and morbidity associated with untreated disease, and the propensity for disease relapse following treatment. There is controversy whether GH or insulin-like growth factor 1 (IGF1), better predicts the onset of cardiovascular complications such as cardiomyopathy and ischaemic heart disease (IHD) in acromegalic patients.Aim: To examine associations of overall GH an...

Background: A cardinal feature of acromegaly is insulin resistance. Patients with acromegaly are therefore predisposed to developing impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM). It is therefore imperative to develop better biomarkers predicting the onset of IGT and T2DM in treated acromegalic patients. There is controversy whether GH or insulin-like growth factor 1 (IGF1) better predict the onset of IGT or T2DM in treated acromegalic patients. However ...

Hyperaldosteronism is a significant cause of secondary hypertension, but there are often delays in obtaining the diagnosis. The recent BES publication of Guidelines for the investigation and management of this condition represent a move to standardise the work-up of these patients.We present an audit of cases, dating back to 2000, with confirmed biochemical hyperaldosteronism (on the basis of plasma aldosterone/renin activity ratio or lack of aldosterone...