Endocrine Abstracts

Case history: A 22-year-old female first presented to our endocrine clinic in 2008 with a six-month history of galactorrhoea and irregular menses.Investigations: She had hyperprolactinaemia (2401 mIU/l), a negative macroprolactin screen and her pituitary MRI scan demonstrated a 4-mm microadenoma. Her cannulated prolactin levels were >1500 mIU/l. She had reverse FSH:LH ratio hence the possibility of PCOS was considered. Her pelvic ultrasound did not s...

Hyperglycaemic hyperosmolar state (HHS) is a common medical presentation, typically occurring in older patients with Type 2 diabetes mellitus. Mortality rates have been reported to be up to 60%. Precipitating factors include dehydration, sepsis, cardiovascular disease and drugs. Here, we describe a rare case of HHS, likely to have been precipitated following the development of lithium-induced nephrogenic diabetes insipidus (DI).A 62-year-old female prese...

Adrenal vein sampling (AVS) is the gold standard for detecting aldosterone production in bilateral adrenal hyperplasia and for distinguishing the lateralization of aldosterone secretion. Successful AVS is determined by calculating the selectivity index (SI). The cut off value for the SI is ≥2.0 under un-stimulated conditions. The aldosterone level (AL) is corrected for cortisol level (CL) and adjusted values are then compared to determine the lateralizing index (LI). Mos...

We present the case of a 35-year-old woman who was well until pregnancy 4y previously in Israel. Her antenatal course was uncomplicated. She breastfed postpartum and a few months into this she experienced acute back pain on reaching for a nappy. MRI demonstrated six vertebral fractures. DEXA scan confirmed osteoporosis (lumbar T-score −4.3, hip T-score −3.3). She received a single dose of denosumab. She moved to the UK 2y later and was referred to our Endocrine Bon...

We present a 52-year-old female with a 26-year history of type-2 diabetes mellitus who has been difficult to treat owing to the development of multiple insulin allergies. She initially developed local hyperpigmentation and itchy swellings at the injection sites of her Humulin I in 2016, with similar symptoms occurring when she was switched to NovoRapid. Additionally, she developed one severe, systemic reaction to Humulin I. All insulin treatment was stopped, and she was left s...

A 22-year-old male presented to the Emergency Department with nausea and vomiting. He reported thirst, polyuria, reduced appetite and weight loss. He did not have pre-existing medical conditions and did not take regular medications. On examination, he appeared pale and clammy. He was apyrexial, tachycardic and tachypnoeic with normal blood pressure and oxygen saturation. His chest was clear and abdomen generally tender. A venous blood gas revealed pH 6.94, base excess −2...

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...

A 32 year old Polish gentleman presented following a collapse with preserved consciousness. Preceding this he was noted to have had a rapid deterioration in mobility with worsening weakness in all four limbs. On further questioning the patient had been diagnosed with hyperthyroidism two months previously and was being treated with propylthiouracil. Positive examination findings included tachycardia with upper limb weakness with 2/5 power bilaterally and lower limbs weakness wi...

Objective: To identify the radiological characteristics of adrenal abnormalities as reported on CT abdomen;To identify functional characteristics of adrenal incidentalomas; To identify 12 month outcomes of adrenal incidentalomas1500 consecutive unselected computerised Tomograms(CT abdomen) done for non-adrenal indication, reviewed for adrenal abnormalities to identify, the incidence size, radiological density, those with abnormalities underwent endocrine...

The incidence of type 1 diabetes mellitus (T1DM) is rising. The demands of daily management, blood glucose variability and potential complications pose challenges in management of T1DM.The aim of this study was to determine the clinical and metabolic profiles of T1DM patients attending Midland Regional Hospital Portlaoise diabetes service in 2017 and to assess their microvascular and macrovascular complications.A retrospective anal...