Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder of uncertain aetiology, affects 1 in 10 reproductive women and has broad spectrum risks related to reproductive, cardiometabolic and psychosocial health. The wide overlap with other hyperandrogenemic conditions, complexity of PCOS spectrum, and inconsistencies in investigation and management potentially can result in risks of delay in diagnosis and management.Aim: To evaluate ...

Background: During Covid-19 pandemic, we recognised the importance of optimising adrenal insufficient patients’ ability to manage adrenal crisis and seek medical intervention thereby reducing the need for more intensive support. Evidence suggests omission of steroids during an adrenal crisis is a medical emergency and can be fatal. Research by National Reporting Learning System (2020) identified 4 deaths, 4 admissions to critical care, 320 incidents relating to steroid re...

Introduction: Primary hyperparathyroidism (PHPT) is an endocrine condition in which autonomous excessive secretion of parathyroid hormone (PTH) results in hypercalcaemia. In approximately 80% of cases the aetiology is due to a single parathyroid adenoma, the remainder are due to hyperplasia of more than one gland. Familial Hypocalciuric Hypercalcaemia (FHH) is an autosomal dominant, inactivating mutation of the calcium-sensing receptor, causing a right-shift in the concentrati...

Objectives: Congenital adrenal hyperplasia (CAH) is a rare condition caused by enzyme deficiency in cortisol biosynthesis. Patients with CAH require lifelong therapy, with the aim of replacing deficient hormones (cortisol +/− aldosterone) and reducing excess androgen production. Guidelines state that the lowest effective glucocorticoid (GC dose) should be used; however, current GC therapy is suboptimal, and supraphysiological GC doses are used to reduce excess androgens....

63 years old with sarcoidosis since 2018 and type 2 diabetes was referred by GP for hypercalcemia related to likely dehydration and sarcoidosis. She was started on a weaning dose of prednisolone and empagliflozin. She had already been on metformin for several years. She was discharged after calcium improved from 2.97 mmol/l to 2.83 mmol/l. She was advised to follow up in Ambulatory care in 1 week for repeat calcium levels. On follow up, noted to have calcium levels of 2.67 mmo...

81-year-old ex-smoker presented to emergency with transient facial droop, slurring of speech and generalized weakness. He had a background of ischemic heart disease, hypertension, and previous bladder cancer (treated 5 years ago). Examination revealed clinical signs of hypocalcaemia with no cushingoid features. Bloods revealed refractory severe hypokalemia, severe hypocalcaemia with normal phosphate, and metabolic alkalosis requiring High dependency Unit.<p class="abstext"...

Background: Tuberculosis (TB) is an important cause of mortality and morbidity globally. Only a small proportion cases of systemic TB present with lesions spreading to meninges, sella, or ventricles. Cases of intra-sellar pituitary adenoma secondary to TB have been rarely identified, often with uncertainty on medical management as opposed to more aggressive surgical therapy. We report an interesting case of pituitary adenoma presenting with pan-hypopituitarism and posterior pi...

Case history: A 54-year-old lady was diagnosed with primary hypoparathyroidism in 2005, after being referred by her Rheumatologist as her father and brother had familial hypoparathyroidism and sensorineural deafness. She was followed up in endocrine clinic for management of primary hypoparathyroidism. Her hypocalcaemia is well managed with calcium supplementation, with no specific symptoms of hypocalcaemia. She has recurrent urinary tract infections with known borderline chron...

Introduction: Childhood papillary thyroid carcinoma (CPTC), despite bilateral thyroidectomy (BT), nodal resection and radioiodine remnant ablation (RRA), recurs within neck nodal metastases (NNM) in >30% within 20 postoperative years. However, these NNM are usually treated with re-operation or further radioiodine; US-guided ethanol ablation (EA) may be considered (j.sempedsurg.2020.150920) for patients with limited numbers of NNMMethods: We studied l...

45 years old male of Romanian origin presented with shortness of breath and reduced exercise tolerance over 3 months with increased sweating and weight gain from 90 kgs to 118 kgs over 2 years. Also reported hands/fingers/feet size increase. He also complained that his breathlessness worse by as tongue and lips were ‘large’. Denied any visual disturbance, especially peripheral vision. On examination, coarse features, prognathism and possible macroglossia noted. Photo...