Endocrine Abstracts

Variation in the glucocorticoid receptor (GR) gene associates with relative glucocorticoid resistance, hypertension and increased cardiovascular disease risk in humans. To investigate the contribution of cardiac GR to this phenotype we have characterised adult male mice with cardiomyocyte and vascular smooth muscle deletion of GR (SMGRKO) and have found left ventricular function to be impaired.SMGRKO mice, generated by crossing GR ‘floxed’ mice...

The presentation will start with a review of the relationship with autoimmune thyrotoxicosis and the white cell count. Pre-therapy measurements and on-going measures of checking for leucopenia will be discussed.The evidence for a temporal effect of the thionamides will be reviewed. This will detail the times for increased vigilance and appropriate standard advice for patients initiating thionamides. Dosing and different thionamides and their potential va...

The presentation will start with a review of the relationship with autoimmune thyrotoxicosis and the white cell count. Pre-therapy measurements and on-going measures of checking for leucopenia will be discussed.The evidence for a temporal effect of the thionamides will be reviewed. This will detail the times for increased vigilance and appropriate standard advice for patients initiating thionamides. Dosing and different thionamides and their potential va...

A 33 year old man with Williams-Beuren Syndrome (WBS) was admitted following the finding of symptomatic hypercalcaemia (calcium 3.12 mmol/l (2.2-2.6)). Infantile hypercalcaemia is characteristic of WBS, however almost always, calcium levels return to the normal range by ~12 months of age. The patient also had an acute kidney injury (eGFR 39ml/min/1.732, creatinine 178 mmol/l (59-104)), secondary to hypercalcaemia. The patient complained of polydipsia. Past medical h...

Hypercalcemia is commonly caused by primary hyperparathyroidism. Other causes of hypercalcaemia can be seen in the clinical setting, and it is important to consider these alternative diagnoses as the management differs dramatically from the management of primary hyperparathyroidism. We present a series of four patients presenting with four different granulomatous conditions causing hypercalcaemia. These were secondary to Tuberculosis, Sarcoidosis, Wegener’s granulomatosis...

A 73 year old female presented with collapse secondary to hypoglycaemia. Investigations are summarised in the table attached. In the presence of raised tumour markers and a raised IGF2/IGF1 ratio, carcinomatosis was considered as the most likely underlying diagnosis. Nutritional support was arranged with additional carbohydrate dietary intake advised. She responded well with reduced hypoglycaemic frequency of hypoglycaemia. Investigations for underlying carcinoma were unable t...

A 42 year old female presented with classical symptoms of hypothyroidism. Thyroid function tests confirmed hypothyroidism: TSH >100 mu/L and free T4 7 pmol/L. Thyroid peroxidase antibodies were significantly elevated at >3340 iu/ml. She was started on thyroxine 150 mcg but 3 months later the TSH remained elevated at 45 mu/L. Further review indicated no significant symptomatic improvement and TSH remained high at 61 mu/L. Her thyroxine dose was increased to 200 mcg but ...

A 74-year-old man was referred urgently for investigation of recurrent phaeochromocytoma.In 2006, he was referred to another hospital with nocturnal sweating and tremors. He was found to have a left sided phaeochromocytoma which was removed laparoscopically with uneventful follow up. Unfortunately no initial results or histology were available on referral to our department.Follow up in primary care had involved annual 24 h urinary ...

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=...

We present a case of a 71-year-old gentleman who presented with a clivoid mass to the opthalmologists.The patient presented with left retro-orbital pain. He was generally fit and well, but his past medical history included cancer of the prostate and gout. An MRI brain was performed, which demonstrated a lesion between the left internal carotid artery and the clivus. CT chest/abdomen/pelvis confirmed no evidence of metastatic prostate cancer.<p class=...