Endocrine Abstracts

A 46 year old female presented to orthopaedics with a painful swelling at the base of the middle finger, which was gradually increasing in size. Ultrasound and x-ray showed a highly vascular irregular mass with bony involvement of the third metacarpal. Initial suspicions were of an enchondroma. Following an MRI scan, the orthopaedic team proceeded to biopsy the lesion. The histology suggested a giant cell tumour. Curretage of the lesion, with bone grafting was performed and fu...

Background: Short Synacthen tests (SSTs) are used to assess adrenal function by injecting tetracosactide and measuring blood cortisol after 30 and 60 min. Many SSTs at Royal Bournemouth Hospital (RBH) are undertaken externally to the Bournemouth Diabetes and Endocrine Centre (BDEC). There is an increasing cost-implication for undertaking SSTs exacerbated by recent problems with Synacthen supply. A 0900 h cortisol or random cortisol on acutely unwell patients can be sufficient ...

Background: Short Synacthen tests (SSTs) are used to assess adrenal function by injecting tetracosactide and measuring blood cortisol after 30 and 60 min. Accuracy of timing helps enable successful interpretation of results. A SST is an invasive test although it is normally well tolerated. There is an increasing cost-implication for undertaking SSTs exacerbated by recent problems with Synacthen supply.Method: We undertook a retrospective audit of 333 pat...

Case history: A 42 year old female presented with a history of collapse and seizure activity. Her blood glucose was noted to be 3.1 with the paramedics and subsequent hypoglycaemia was demonstrated on several occasions whilst in hospital. She described a family history of insulinoma in her mother. A 72 h fast was performed as an inpatient to look for insulinoma. The nadir serum glucose was 2.0 mmol/l with an inappropriate C-peptide level of 1006 pmol/l and an insulin level of ...

A 21 year old Caucasian female with no known personal or family history of thyroid disease presented with several years history of anxiety and was found to have abnormal thyroid function tests. Results showed TSH: 1.8 mu/l (0.3–5.5), T4: 73 pmol/l (10–22), T3 12.3 pmol/l (3.1–6.8). Past medical history included chronic anxiety with no regular medications or nutritional supplements. There was no history of recent iodinated contrast administr...

We report a case of a false positive pentagastrin stimulation test in a patient with a positive family history for medullary thyroid cancer (MTC), but normal histology following total thyroidectomy.An asymptomatic 50-year-old man was referred urgently with an elevated calcitonin level of 19.9 ng/l (reference range<11.8), taken following the diagnosis of his brother with MTC which had been discovered on a routine private medical examination. There was...

We have previously demonstrated that 80% of patients with PTHP will have co-existing vitamin D deficiency suggesting an increased metabolism of vitamin D. There are few data assessing the impact and safety of different vitamin D preparations on calcium, parathyroid hormone (PTH) and vitamin D in this group. Here, we report the details of replacement therapy using different vitamin D preparations.In a retrospective study of 22 (20 F:2 M and 8 Asian:14 Non...

The activity of certain hypothalamic neuronal populations is altered by changes in glucose. in-vitro studies have identified several glucose-sensitive neuronal populations in hypothalamic regions controlling energy homeostasis. Subsets of orexigenic arcuate nucleus Neuropeptide Y (NPY)-releasing neurones are known to be glucose responsive. These neurones may allow glucose to influence appetite. Cocaine and amphetamine regulated transcript (CART) is a neurotransmitter ab...

We have previously demonstrated that 80% of patients with PTHP will have co-existing vitamin D deficiency suggesting an increased metabolism of vitamin D. There are few data assessing the impact and safety of different vitamin D preparations on calcium, parathyroid hormone (PTH) and vitamin D in this group. Here, we report the details of replacement therapy using different vitamin D preparations. In a retrospective study of 22 (20F:2M and 8 Asian:14 Non-Asian) patients with co...

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 ...