Endocrine Abstracts

Introduction: Hypercalcaemia diagnosed in hospital setting is most commonly PTH-independent and malignancy related, whilst hypercalcaemia discovered in community setting is commonly secondary to Primary Hyperparathyroidism (PHPT). Other rare causes include granulomatous diseases such as sarcoidosis and familial hypocalciuric hypercalcaemia (FHH).Case Summary: A 73-year-old male with a background of hypertension and chronic kidney disease stage 3 was foun...

Hypoparathyroidism causes severe hypocalcaemia and defective skeletal metabolism. Treatment with calcium and vitamin D supplementation can cause kidney failure whilst native parathyroid hormone (PTH) requires repeated injections and causes renal impairment paralleling high peak and low trough PTH levels. A long-acting PTH, providing constant physiological levels, is needed. LA-PTH, a hybrid of PTH and PTH related peptide, prolongs cAMP responses via altered receptor mechanisms...

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...

A 53 year old male with a history of polysubstance abuse was admitted to A&E, having been found unconscious in the community with a blood glucose level of 1.2 mmol/l. Despite intramuscular glucagon and intravenous 20% dextrose administration, his blood glucose was confirmed to be 2.6 mmol/l on arrival in A&E. Neuroglycopaenia was refractory to multiple dextrose boluses and only stabilised following a continuous 20% 125 ml/hr dextrose infusion. Following admission to th...

Case presentation: A 35-year-old man presented to the emergency department (ED) in a confused and agitated state. His past medical history was significant for poorly controlled type 1 diabetes, complicated by background diabetic retinopathy. He was taking basal/bolus insulin and had a history of diabetic ketoacidosis (DKA) eleven years prior. He also had multiple sclerosis however disengaged with neurology services and was non-compliant with interferon therapy. Prior to admiss...

Case history: A 58 year old woman presented to her GP when her family members noted prominence of her left eye. She had a background history of polycystic ovary syndrome (PCOS). Her main symptom of PCOS was hirsutism. She had been treated initially with the combined oral contraceptive pill ‘Dianette’ (ethinyloestradiol/cyproterone) but had also been treated intermittently with varying doses of 25–100 mg cyproterone acetate (CPA) 10 days/cycle. Post menopause she...

Case presentation: A 35-year-old man presented to the emergency department (ED) in a confused and agitated state. His past medical history was significant for poorly controlled type 1 diabetes, complicated by background diabetic retinopathy. He was taking basal/bolus insulin and had a history of diabetic ketoacidosis (DKA) eleven years prior. He also had multiple sclerosis however disengaged with neurology services and was non-compliant with interferon therapy. Prior to admiss...

Introduction: Leptin is a 16-kDa peptide hormone secreted by adipose tissue and acts as a sensor for energy stores. It feedsback at the hypothalamic arcuate nucleus to suppress appetite. Leptin treatment has been highly effective in suppressing appetite in the rare cases of leptin-deficient obesity and improving the metabolic profile in congenital generalised lipodystrophy. These patients require 2.5–10 mg once daily recombinant leptin treatment. We hypothesised that prol...

A 56-year-old woman, recently commenced on immunotherapy as second-line treatment for advanced non-small cell lung cancer, presented at the hospital critically unwell with severe diabetic ketoacidosis (DKA) (glucose 47 mmol/l, blood ketones 7.5 mmol/l, pH 6.95, bicarbonate 6.6 mmol/l). One week prior to presentation, she was clinically well with random glucose of 6.1 mmol/l. Following admission to Intensive Care Unit, she responded well to standard treatment for DKA and discha...

Background and aims: Electrolyte imbalance is common among hospital inpatients, reflecting severity of underlying illness, but also independently contributing to excess morbidity and mortality. However, studies have largely been retrospective, with incomplete data capture. We prospectively evaluated the prevalence of major Na and Ca disorders among inpatients at the Newcastle-upon-Tyne Hospitals.Method: With approval of the Information Guardian, we used ...