Endocrine Abstracts

Introduction: Neuroendocrine tumors (NET) are very rare and often present a diagnostic challenge. They are often misdiagnosed due to non-specific symptoms. We report a rare case of NET presenting to a non endocrine unit.Case: A 72-year-old Caucasian female was referred for refractory diarrhoea with hypokalaemia. In addition, there was history of significant weight loss over few months.She had past medical history of diabetes, hyper...

Twelve-month-old GK rats that showed glucose intolerance were compared with age matched Wistar rats. The concentrations of noradrenaline (NA), adrenaline (ADR) dopamine (DOP), Neuropeptide Y (NPY), and calcitonin gene-related peptide (CGRP) were measured in tissue samples. The objective was to assess whether glucose intolerance was associated with changes in the noradrenergic and peptidergic nerves innervating the tail artery (TA), seminal vesicle (SV) and corpus cavernosum (C...

Case: A 74-year-old female presenting with central weight gain, proximal myopathy, thin skin and bruising. Clinical examination identified central obesity, round facies, dorso-cervical and supra-clavicular fat pads.Investigations: Bloods revealed hypokalaemia (3.2mmol/l), elevated cortisol levels (>1000nmol/l) persisted post low dose Dexamethasone suppression test, with a supressed ACTH (<5). Urine free cortisol 1842nmol/24hrs (0-165). CT Chest-A...

Introduction: Hyperparathyroidism in pregnancy is rare and is associated with significant maternal and fetal morbidity and mortality. Recognition can be challenging due to the inability to differentiate hypercalcaemia symptoms from those of pregnancy, studies suggest that up to 80% of cases may be undiagnosed. We report three cases of hyperparathyroidism in pregnancy at Royal Derby Hospital, investigations (Table 1) and management in these patients are reviewed.<p class="a...

A 29 year old female presented with a two year history of recurrent numbness and tingling in her hands. Trousseau’s sign was positive. Investigations confirmed hypocalcaemia with serum calcium 1.64 nmol/L (2.10–2.60), phosphate 1.23 nmol/L (0.80–1.55), alkaline phosphatase 82 U/L (35–120). Parathyroid hormone was inappropriately normal at 36 pg/ml (10–65), Vitamin D 78 nmol/L (50–75). Her mother reported a history of hypocalcaemia when she was two...

We present a case of 55 years old obese man with type 2 diabetes of 13 years duration, seen in diabetes clinic. His HbA1c had been 8–10% for about 7 years despite being on maximum doses of sulphonylurea and metformin.It was decided to start him on 30/70 mixed insulin and Metformin was continued. His HbA1c did not improve despite aggressive insulin titration. His injections became painful as insulin doses increased and resistance was noted on injecti...

Introduction: We describe the case of a patient referred to Cardiology with an abnormal ECG & hypertension. Investigation led to the diagnosis of catecholamine induced cardiomyopathy caused by a pheochromocytoma. The case is unique as the cardiomyopathy was reversed with alpha and beta blockade prior to surgery.Case: A 56 year old female with 20 pack year smoking history, no regular medications and evidence of hypertension underwent CT AP for abdomin...

The management of childhood obesity has evolved from hospital led treatment to community-based programmes. This is an audit reviewing the impact of the active children eating smart (ACES) programme for overweight/obese children on the dietetic department in the Royal Hospital for Sick Children; Glasgow. A retrospective audit was carried out of referrals to the dietetic department. Clinic lists for dietetic appointments in 2008 and 2010 were identified and reviewed. In 2008 and...

A 53-year-old man was referred for assessment of diabetes insipidus. He had been treated with intranasal desmopressin from18 months of age on the basis of an extensive family history but without confirmatory testing. The current referral was because of hyponatraemia in a similarly affected relative, which had raised uncertainty about diagnosis and treatment.The family history included 11 affected individuals across four generations and suggested autosoma...

Mutations of the RET proto-oncogene are associated with MEN and FMTC and aid diagnosis and predictive testing in family members. Genotype-phenotype correlations are also used to plan therapeutic decisions. We describe a 4 generation family with a rare E768D mutation in exon 13. The index case was diagnosed with MTC at age 54 and remains free of clinical disease 11 years following thyroidectomy and neck irradiation. 2 further family members were identified with MTC at age 25 an...