Endocrine Abstracts

A 72 year old lady presented to Endocrinology in 2001 with primary hyperparathyroidism and had a parathyroid adenoma resected, resulting in normocalcaemia. In 2006, she developed mild hypercalcaemia (2.61-2.71 mmol/l) and underwent extensive investigations for recurrent PHPT. Parathyroid localization studies, including FDG PET, failed to identify any adenoma. The patient declined bilateral neck exploration and she was managed conservatively. A DEXA scan showed evidence of oste...

A 70-year old female patient was referred to the Endocrine clinic after incidental finding of significant hypercalcaemia (3.19 mmol/l, NR: 2.20-2.60 mmol/l) during work-up for cognitive decline. She had a known background of T2DM, hyperlipidaemia, osteoarthritis with a previous right total hip replacement and a laparoscopic cholecystectomy. She was first reviewed in clinic in June 2022 and was almost asymptomatic, except for memory issues. She denied previous history of renal ...

Background: Hyponatraemia is the commonest electrolyte abnormality. It carries a mortality rate of above 50% when plasma sodium concentration falls below 115 mmol/L. We present a case of severe hyponatraemia complicating pre-eclampsia in a primiparous woman.Case Report: A 23-year old healthy primigravida was admitted at 34 weeks’ gestation following an episode of reduced foetal movements. She was hypertensive (BP 171/98 m...

Background: Hyponatraemia is the commonest electrolyte abnormality. It carries a mortality rate of above 50% when plasma sodium concentration falls below 115 mmol/L. We present a case of severe hyponatraemia complicating pre-eclampsia in a primiparous woman.Case Report: A 23-year old healthy primigravida was admitted at 34 weeks’ gestation following an episode of reduced foetal movements. She was hypertensive (BP 171/98 m...

Case report: A 29-year old Caucasian male was referred to our Endocrinology Outpatient Clinic following a recent admission after an episode of collapse when he was noted to have abnormal thyroid function tests: fT4 32.6 (7.5–21.1) pmol/l, TSH 6.41 (0.34–5.6) mU/l. These were repeated and again showed elevated fT4 26.9 pmol/l and normal TSH 2.29 mU/l. He reported some tremor of both hands but denied palpitations. He was clinically euthyroid but p...

Introduction: Hypoglycaemia remains the major barrier to tight glycaemic control in diabetes. Oral hypoglycaemic agents such as sulphonylureas (SU) remain one of the main options for managing type 2 diabetes mellitus (T2DM), but the glucose independent action is associated with an increased risk of hypoglycaemia. We present a retrospective audit of patients attending the A&E Department with severe hypoglycaemia at a large acute trust serving a population of 450 000.<p ...

Background: Lithium-associated hyperparathyroidism (HPT) is an under-recognised side effect of chronic lithium therapy. Cessation of lithium may precipitate relapse of psychiatric illness. Potential treatment with cinacalcet has been described in two case series recently.Aim: We present two cases of HPT secondary to lithium therapy used for bipolar affective disorder, which were successfully managed with cinacalcet.Results: Patient...

Background: Primary hyperparathyroidism (PHPT) and concomitant medullary thyroid disease is well described in literature as part of multiple endocrine neoplasia. However, coexistence of PHPT and papillary thyroid cancer (PTC) has only been scarcely documented in sporadic case reports and some surgical series.We present two unusual cases of PHPT associated with synchronous multifocal PTC.Cases: A 62-year-old woman with sporadic PHPT...

Case history: A 30-year old female presented with a 10-month history of enlarging neck mass, fatigue and weight gain. Assessment by her GP found her to have a large smooth goitre and biochemical hypothyroidism. The patient had a history of intestinal failure secondary to mitochondrial disorder. As a result of intestinal failure she was entirely dependent on parenteral nutrition and was intolerant of any oral intake, with venting of her stomach to reduce pain. She was referred ...

Introduction: Primary hyperparathyroidism (PHPT) is a common endocrine disorder. However, a familial hyperparathyroid syndrome is diagnosed in less than 5% of cases. We present two related cases of CDC73-related familial hyperparathyroidism due to a rarely described germline Leu63Pro missense mutation in CDC73 exon 2.Case report: The index patient, a 24-year-old female, presented acutely unwell with symptoms of hypercalcaemia. Her blood...