Endocrine Abstracts

Cardiac phaeochromocytomas account for only 1% of all extra-adrenal phaeochromocytomas. We present a rare case, which through a multidisciplinary approach achieved an excellent outcome. A 49-year-old male presented with chest pain. Echocardiography revealed a pericardial mass behind the left atrium and subsequent cardiac angiography confirmed a highly vascular lesion, suspicious for a phaeochromocytoma. Urine and plasma metanephrines were elevated; urine normetadrenaline 10888...

Background: Congenital adrenal hyperplasia (CAH) is the commonest genetic endocrine disorder, affecting 1 in 18 000 UK births. The 2010 CaHASE Study identified a myriad of health problems associated with CAH and its treatment, and a lack of consensus on treatment strategies in adults. Endocrine Society guidelines (2010, revised 2018) have since been published to support management. As one of the original CaHASE centres, we have audited our recent practice against these new sta...

Case history: A 68 year old woman was referred to Endocrinology with a history of vomiting, extreme fatigue of acute onset and non-specific visual changes. She had a history of primary hypothyroidism and an adenocarcinoma of the lung with bone metastases initially been treated with pemetrexed and cisplatin chemotherapy. The patient subsequently required palliative radiotherapy for metastatic spinal cord compression and was started on denosumab. Imaging shortly before her refer...

Background: Suboptimal glycaemic control in hospital inpatients is related to poor clinical outcomes and longer hospital stay. The aims of this study were to document the prevalence and severity of hypo- and hyperglycaemia in medical inpatients and to evaluate aspects of patient management and staff proficiency regarding glucose management.Methods: We performed a retrospective review of 21 381 capillary blood glucose results in 1496 unique patients on 26...

A 54-year-old lady presented with malaise, weakness, and constipation. She was found to be mildly hypercalcaemia (adjusted calcium 2.68–2.76 mmol/l; reference range 2.12–2.60 mmol/l) and was referred to local endocrinology services. Her PTH was 79 ng/l (range 10–60) and a diagnosis of primary hyperparathyroidism was made. Imaging to localise a parathyroid source was negative. She was referred to the endocrine surgeons at the Royal Victoria Infirmary, Newcastle, ...

Introduction: Pituitary apoplexy is an uncommon medical emergency with a reported incidence in pituitary adenomas of 2–7%. UK guidelines on the management of pituitary apoplexy have recently been published. On this background we analysed the management of pituitary apoplexy at a single tertiary centre.Methods: A retrospective analysis was performed to evaluate clinical presentation, management and clinical outcomes in a cohort of patients, who prese...

Sialic acid acetylesterase (SIAE) has been found to be essential for the maintenance of immune tolerance in mice by negatively regulating B lymphocyte antigen receptor signalling. Recently, numerous rare heterozygous loss-of-function germline variants and a homozygous functionally defective variant of the SIAE gene (M89V) have been identified as conferring a strong genetic susceptibility to several autoimmune disorders, including T1DM and rheumatoid arthritis. We performed a c...

Background: Thyroid hormone replacement is one of the most commonly prescribed and cheapest treatments for a chronic disease. There have been recent changes in community prescribing policies in many areas of the UK that have changed patient access to necessary medications.Aim: To provide a picture of thyroid hormone usage in the UK and to survey patient opinion about current community prescribing policies for levothyroxine.Methods:...

Thyroid function changes with advancing age, however there is little good quality data available that characterises the extent of thyroid disease in the elderly, or the parameters of normal thyroid function in the ‘oldest old’. Reference ranges for serum TSH and free thyroid hormones based on unselected younger adults are currently applied uniformly to older individuals.The Newcastle 85+ study has collected health and lifestyle information from...

A 69-year-old man with no family history of thyroid disease presented with weight gain and constipation. He was clinically euthyroid with no goitre. Investigations confirmed autoimmune hypothyroidism with FT4 16.9 pmol/l (N: 10–22), TSH 29.14 mIU/l (N: 0.4–4.5), elevated thyroid peroxidase (TPO) antibodies 3311 IU/ml (N: 0–34) and he was commenced on thyroxine with serial dose adjustments to 250 mcg OD over 2 years. His TSH however remained ...