Endocrine Abstracts

We describe a 82 year old patient with background history of thyrotoxicosis (had total thyroidectomy), primary hyperparathyroidism (had parathyroidectomy 12 years back at another hospital – two glands removed). She was on L-thyroxine, alfacalcidiol 1 μg/day and CaCO3 500 mg BD. She remained stable for 7 years on this cocktail. In February 2017, she was admitted with acute confusion and was found to have adjusted ca level of 4.57 with AKI, no...

: 39Y old male who was originally treated as child with CAH secondary to 21-Hydroxylase deficiency and was put on glucocorticoids and mineralocorticoids from first week of life due to salt wasting crises. He has had very high 17-OH progesterone and adrenal androgen due to noncompliance. He developed polycythemia secondary to androgen excess, resulted in venesection. Haematologist have investigated the mutation and EPO measurement and he felt that this was probably secondary po...

This is the case 32y old Asian lady, who first presented to her GP in October 2013 with weight loss, palpitations and fatigue and found to have overactive thyroid. She has not experienced any neck pain or systemic illness. She has some neck tenderness but not goitre or any extra-thyroidal manifestation of Graves’ disease, hence the thyroid nucleotide scan was requested. His scan was consistent with thyroiditis. By January 2014 her thyroid function test normalized with TSH...

Background: PCOS women usually have metabolic disturbances particularly insulin resistance. Previous studies suggest that vitamin D deficiency may contribute to the development of insulin resistance. Our aim is to study the effect of vitamin D supplementation on clinical and biochemical parameters in vitamin D deficient PCOS women.Methods: At baseline, 50 PCOS women were enrolled (37 vitamin D deficiency and 13 vitamin D sufficiency). Thirty-seven PCOS w...

Background: Dyshormonogenetic goiter and Hashimoto’s thyroiditis are amongst the commonest causes of hypothyroidism in children and adolescents Worldwide. But, the genetic basis and their hypothyroid phenotypes are under-reported, especially from developing countries. In this context, we screened for dyshormonogenetic mutations in hypothyroid children with dyshormogenetic goiter (DH) and Hashimoto’s thyroiditis (HT).Material and methods: In thi...

Background: Vitamin D deficiency and GDM are highly prevalent with long term implications. Prospective studies to analyse the effect of vitamin D supplementation on glucose tolerance in pregnant women are limited.Objectives: Objectives of the study are: 1) To determine the relation between vitamin D deficiency and HOMA indices and glucose tolerance in the first trimester among pregnant women. 2) To study the effect of vitamin D supplementation on HOMA in...

A 24 years old veterinary nurse presented to the cardiology outpatient clinic with palpitations, breathlessness and lethargy. There was no history of weight loss. She had a past history of bulimia. She was clinically euthyroid. ECG demonstrated sinus tachycardia with heart rate of 120 bpm. Thyroid functions test (TFT) done by GP was normal. She was initially treated with beta-blockers.She was subsequently admitted to hospital a month later with palpitati...

Background: Knowledge of glucocorticoid use during acute illness is widely known, however, knowledge of Diabetes Insipidus (DI) is suboptimal amongst healthcare professionals. In 2009, a series of medical and management failures led to the death of 22 year old from DI in a London hospital. Since then increased efforts have been made to raise awareness about the inpatient management of DI and dangers associated with delay and/or omission of desmopressin. An NHS England patient ...

Background: Vitamin D is important for calcium homeostasis. In granulomatous diseases including tuberculosis (TB), hypercalcaemia may be seen. Suspected mechanisms include elevated vitamin D sensitivity and increased extrarenal synthesis of 1,25-dihydroxyvitamin D [1,25(OH)2D] by alveolar macrophages within granulomas. Prevalence of hypercalcaemia in TB patients vary worldwide, yet is rare in the UK. We present a case of hypercalcaemia in a patient with TB reactivat...

Pheocromocytomas (PHEO) are catecholamine secreting tumours which can occur sporadically or as part of other hereditary/familial syndromes including Neurofibromotosis 1 (NF-1). Unlike the case with other genetic syndromes, the current neurofibromatosis guidelines do not recommend a routine hormonal screening strategy for PHEO in the absence of hypertension or other symptoms. In this paper we describe 2 asymptomatic and normotensive patients with NF-1 where secretory PHEO were ...