Endocrine Abstracts

Background: Despite relevant evidence that the absorption and/or action of L-thyroxine is compromised by various factors including the diet, until 2014 the British National Formula (BNF) recommended that L-thyroxine be taken ‘preferably before breakfast’ only, with no further clarifications. To follow is one of the cases where untimely food intake in hypothyroid patients manifested with severe hypothyroidism due to L-thyro...

An 81-year-old lady was referred with a 2-month history of frontal balding and hirsutism over the face and chest that required daily shaving. Her symptoms were progressing weekly. She did not have any history of hot flushes, voice changes or weight loss. Clinical examination revealed marked hirsutism over the face, neck, upper back, thorax and abdomen with a fullness in the right iliac fossa. She had a past medical history of hypertension and hypercholesterolemia.<p class=...

Aim: Retrospective survey on outcomes of 131I therapy in subjects with hyperthyroidism.Methods: We analysed the outcomes at 1 year, of 55 episodes of 131I therapy in 52 patients (36 males, 15 females) who were treated between January 2007 and January 2009.Results: At 1 year post 131I therapy, 31 (56.3%) subjects were hypothyroid (median age 54 years), 14 (25.5%) were euthyroid (median age 69 years) ...

Introduction: Di George’s syndrome is a rare congenital disease that is usually diagnosed in childhood due to its presentation with velo-cardio-facial abnormalities.Case report: A 42-year-old man was incidentally found to be hypocalcaemic (corrected calcium 1.71 mmol/l) during a ‘well-man check’. A subsequent parathyroid hormone (PTH) was inappropriately low at 0.8 pmol/l (reference range 0.5–4.4 pmol/l).He was ...

Case report: A 67-year-old female with untreated congenital adrenal hyperplasia (21-hydoxylase deficiency) was diagnosed with bilateral vulval carcinomata. She was referred to another unit with serum sodium of 121 mmol/l, potassium 4.6 mmol/l and 17-hydroxyprogesterone of 714 nmol/l (0–14 nmol/l). A short synacthen test performed in the evening demonstrated a baseline cortisol of 558 nmol/l, rising to 643 nmol/l at 80 min. The baseline cortisol was deemed adequate but in ...

Thyroid dysfunction is not uncommon in pregnancy and is associated with various maternal, foetal and neonatal complications. We report the occurrence of neonatal hyperthyroidism in two successive pregnancies in a post radio-ablation mother with Graves’ disease who is on thyroxine replacement.Mother: A 30-year-old lady, treated for Graves’ thyrotoxicosis with radioiodine 10 years ago, was on thyroxine 100 mcg replacement for hypothyroidism. She ...

Background: Short Synacthen test (SST) is being increasingly used in various clinical conditions, mainly for completion purpose of ruling out adrenocortical insufficiency rather than actively suspecting it (for instance hypothyroidism with tiredness, type 1 diabetes with hypoglycaemia). The aim of our retrospective analysis was to assess if a random cortisol could predict the outcome of SST.Method: Data were collected on all SST done at the endocrine uni...

Proton pump inhibitors (PPI) are widely prescribed. PPI-induced diarrhoea and hypomagnesaemia are well-documented in literature. Hypomagnesaemia is well-known to cause functional hypoparathyroidism. We describe a patient who had transient profound hypoparathyroidism which improved on discontinuing PPI and normalising severe hypomagnesaemia.A 72-year-old male, who was on oral anti-diabetic medications, calcium/vitamin D3 supplements and PPI, presented wit...

Background: Mullerian agenesis or Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a congenital failure of the Mullerian duct to develop, resulting in complete or partial absence of the cervix, uterus, and vagina. It can be isolated (MRKH type I) or associated with renal, vertebral, and, to a lesser extent, auditory and cardiac defects (MRKH type II). Pituitary disease is not a known association. We report a patient who has isolated MRKH syndrome (MRKH type I) and a pituitary...

Introduction: Diabetes-related Ketoacidosis (DKA) is a commonly-encountered acute endocrine emergency requiring prompt recognition and treatment. DKA is triggered by risk factors that are often preventable. There are limited studies evaluating the precipitating causes of DKA and depicting their trends over the years. The latter is important in the prevention of DKA by ensuring appropriate education and interventions.Aim: To study the trends of aetiologie...