Endocrine Abstracts

Patients with hypoadrenalism are at risk of life-threatening events if they do not receive adequate glucocorticoid replacement during intercurrent illness. We think that these patients should know when and how to adjust their steroid dose when ill. We also think they should possess, and know how to give themselves, an injection of hydrocortisone for emergencies.Current education is given ad hoc at clinic visits, supported by written information, but ther...

Background: There is a well-documented relationship between lithium exposure and thyroid dysfunction via multiple mechanisms. Lithium is commonly associated with goitre, hypothyroidism, and subclinical hypothyroidism. Lithium-induced autoimmune hyperthyroidism is rare and poorly understood. We report a case of autoimmune thyroiditis, Graves’ disease (GD), in a patient with longstanding primary hypothyroidism believed to be induced by Lithium.<p class=...

Background: The NCYPDN plan describes a care model where children, young people (CYP) and families ‘co-design their care plan during appointments’ and ‘have a say in service planning.’ RCPCH ‘Voice Matters’ notes children want clinicians to ‘better understand how we are feeling, to ensure we’re involved in our treatment and have the support we need’. Our clinic experience found some CYP we...

We present a case of severe thyroid-associated orbitopathy in a 44-year-old man with metastatic follicular carcinoma of the thyroid. He presented with a neck lump, and following further investigations, underwent a hemithyroidectomy followed by a completion thyroidectomy. Histology of the thyroid confirmed widely invasive follicular carcinoma of Hurthle cell type with foci of vascular invasion (pT3 Nx Mx). He received radioactive iodine ablation therapy (3.7GBq), ...

We present a case of severe thyroid-associated orbitopathy in a 44-year-old man with metastatic follicular carcinoma of the thyroid. He presented with a neck lump, and following further investigations, underwent a hemithyroidectomy followed by a completion thyroidectomy. Histology of the thyroid confirmed widely invasive follicular carcinoma of Hurthle cell type with foci of vascular invasion (pT3 Nx Mx). He received radioactive iodine ablation therapy (3.7GBq), ...

Introduction: Normocalcaemic hyperparathyroidism (nHPT) is a persistently elevated parathyroid hormone (PTH) with normal ionised calcium levels in the absence of secondary hyperparathyroidism. nHPT is proposed to be an earlier phase of hypercalcaemic primary hyperparathyroidism (PHPT). nHPT patients can present with progressive complications such as osteoporosis and nephrolithiasis. Currently, there is no diagnostic test to confirm primary hyperparathyroidism in nHPT patients,...

Case report: Central neurocytomas are well-differentiated rare central nervous system tumours. These tumours when identified in brain parenchyma or spinal cord are termed as extra ventricular neurocytomas. We report a case of 40 year old lady with mild hypertension who presented with long standing history of intermittent headaches which got worse 2 months before presentation, mainly affecting her forehead and left retro-orbital region. She also noted blurring of vision in her ...

Section: Case history: 73-year old gentleman referred from GP with a two month history of worsening dizziness, malaise, postural hypotension and general deterioration and spiking pyrexia ranging 38-40°C over 3 weeks. PMH of NSCLC T2b N0- left lower lobectomy & chemotherapy 3 years prior.Section: Investigations and treatment: At re-presentation his CT TAP showed bilateral bulky adrenal glands but no other abnormality. The patient’s bloods sh...

Background: A large proportion of patients who attend the Endocrine clinic have thyroid dysfunction, usually thyrotoxicosis. These patients require regular thyroid function tests (TFTs) and advice on medication dose alteration, usually through frequent clinic appointments. At our University Teaching Hospital, we have a nurse-led system whereby TFT monitoring and advice is managed virtually, with patients usually attending clinic annually for review. We call this the Thyroid Sh...

A 70-year-old lady, with a background of primary hypothyroidism presented to the Emergency department with a 1 day history of confusion and drowsiness. On examination her HR was 58 bpm, temperature 28 degrees celsius. She was resuscitated with warm fluids and bair hugger, whilst also given broad spectrum intravenous antibiotics. Her blood results showed an AKI with creatinine of 213 and was treated for a NSTEMI with a troponin on admission of 1770, rising to 2190. ECG showed p...