Endocrine Abstracts

A 60-year-old Caucasian lady was referred to the metabolic bone clinic for assessment of osteoporosis. Her risk factors for osteoporosis included gender, postmenopausal status, childhood immobility due to illness, previous severe vitamin D deficiency, COPD, as well as an extensive smoking and alcohol history. She had multiple previous fragility fractures involving her ribs and both radii. A DEXA scan revealed lumbar osteoporosis (T -4.0) and femoral osteopenia (T -2.0). Thorac...

Patients with Adrenal Insufficiency are potentially at risk of life threatening events if during intercurrent illness they do not take adequate glucocorticoid replacement. The National Institute for Health and Care Excellence Clinical Knowledge Summaries for this patient group recommend that they should: know how to self inject intramuscular hydrocortisone in an emergency; how to adjust their steroid replacement in response to illness; understand the importance of medical iden...

Introduction: The impact of ethnicity and socioeconomic status (SES) on glycaemic control in children with type 1 diabetes (T1D) is poorly understood in England and Wales.Methods: We studied 18 478 children and young people with T1D aged <19 years attending diabetes clinics in England and Wales and included in the 2012–2013 National Paediatric Diabetes Audit (NPDA). Self-identified ethnicity was categorized as white, Asian, black, mixed, other a...

Grave’s orbitopathy typically presents with symptoms of proptosis and diplopia. It is an autoimmune condition of retro-orbital tissues. We present a case in which the management of orbitopathy has been complex and required escalation to immunosuppression and consideration of biological agents. A 34-year-old female presented with 2 weeks of diplopia. She had normal visual acuity with no past medical or family history. She never smoked. Thyroid eye disease was diagnosed, sh...

Tumour induced hypoglycaemia is a rare disorder occurring in cancer patients caused by variety of tumours including islet and non-islet tumours. Non-islet cell tumour induced hypoglycaemia (NICTH) is rare paraneoplastic disorders normally associated with pleural solitary fibrous tumour but can also rarely occur in extra thoracic site.We describe an 86-year-old man not known to have diabetes mellitus who presented with 3-month history of early morning hea...

The mammalian natriuretic peptide family consists of three members, Atrial-, B-type, and C-type natriuretic peptides (ANP, BNP, and CNP respectively), and exert their effects on blood pressure, sodium homeostasis, growth and reproduction, via their selective guanylyl cyclase receptors, GC-A or GC-B. Previous attempts to map spatial expression profiling have generated conflicting results, due predominantly to the range of techniques employed, and the relative paucity of tools t...

Introduction: Vitamin D deficiency is common in ethnic minority population living in UK. It is a relatively easily treatable condition. However, if left untreated it may lead to chronic secondary hyperparathyroidism and onto tertiary hyperparathyroidism. We report three cases of severe vitamin D deficiency who presented with hypercalcaemia.CasesWe report three patients. 60 and 46 years old ladies, both of south-asian origin, a 46 y...

Craniopharyngiomas are tumours which grow in the region of the sella, with adamantinomatous (ACP) and papillary (PCP) subtypes. While usually ‘benign’, They can have devastating long term sequelae, both from the mass effects of the tumour itself on the visual, pituitary or hypothalamic pathways, but also from the neurosurgical challenge to achieve tumour control with preservation of the surrounding pituitary and hypothalamic pathways. To date there is no satisfactory...

Since 1994, after initial outpatient review (OPD) for thyrotoxicosis, we have minimised OPD attendance and provided shared-care advice to primary care physicians on thyroid function tests (TFT) and anti-thyroid drug (ATD) and levothyroxine (T4) dose titration using our electronic patient record (EPR). Using EPR data we analysed treatment (Rx) choice, effectiveness and outcomes, classifying patients as autoimmune (+ve TPO or other Graves’ features), nodular, mix...

Introduction: British Thyroid Association Guidelines state that the diagnosis of thyroid malignancy cannot be based on the results of an aspiration’s cytology alone and will usually require surgical removal for confirmation. There has been much debate about the management of indeterminate fine needle aspirations (Thy 3). Recent publications have reported that the prevalence of thyroid carcinoma following a Thy 3 result to be as high has 28%, emphasising the importance of ...