Endocrine Abstracts

A 37-year-old female, referred by gynaecologist with low prolactin and free T4 after work up for secondary amenorrhea despite removal of contraceptive coil 18 months ago. Her only daughter was born seven years ago with no complications. Patient admitted to have tiredness and dizziness for a few years but denied headache or visual symptoms. Pituitary hormone profile confirmed secondary hypothyroidism, secondary hypogonadism, low prolactin, low IGF-1 level but normal adrenal axi...

Patients with Cushing’s syndrome usually have characteristic phenotypical features but this is not always true in case of Ectopic ACTH secretion. This is mainly because this develops more acutely and underlying malignancy can cause significant weight loss. We report a 71 years old male with background of Prostatic malignancy who was found to have new profound hypokalaemia which was resistant to treatment. There were no signs of Cushing’s syndrome but index of suspici...

Introduction: Primary hyperparathyroidism is associated with numerous cardiovascular complications including hypertension, left ventricular hypertrophy and calcification of cardiac valves. However, guidelines from expert panels and NICE have not included cardiovascular complications as an indication of parathyroidectomy. This literature review will be focused on benefits of parathyroidectomy on cardiovascular complications of primary hyperparathyroidism....

Aims and objectives: Variable rate insulin infusion (VRII) is commonly used to achieve normoglycaemia in hospitalised patients. Joint British Diabetes Society (JBDS) produced guidelines on VRIII in 2014 to minimise complications related to inpatient VRII use. Local guidance along with a new VRII chart was introduced in 2017 at the West Suffolk NHS Foundation Trust and staff training provided. We performed an audit to review compliance to national and local VRII guidance.<p...

Cardiac failure is a rare manifestation of thyrotoxicosis in patients without heart disease. However, patients with prior cardiac failure are at high risk of decompensation with thyrotoxicosis. Amiodarone is a widely used antiarrhythmic agent and amiodarone induced thyrotoxicosis (AIT) is not an uncommon complication. We present a case. A 48-year old male with intermittent atrial flutter, dilated cardiomyopathy, myocardial infarction and stroke was referred for severe thyrotox...

Aim: We present an unusual case of long-term accidental ingestion of androgenic steroid in a young female.Case: A 28-year-old lady presented with male pattern of hair growth, weight gain of three stones, change in voice, and secondary amenorrhea. On direct questioning she admitted she was taking ‘fat bursting pills’ for nearly 6 months, obtained from a gym, to lose weight. Examination revealed a blood pressure of 150/77 mmHg, increased muscle b...

A 39-year-old lady with severe primary hypothyroidism was referred to the endocrine clinic. Her past medical history includes intermittent colitis and Irritable Bowel syndrome. There was no history of diarrhoea for the last 1 year. TSH 97.2 mU/l (0.3–5.0) and free thyroxine (T4) was 5.0 pmol/l (10–22). The dose of levothyroxine was increased gradually from 100 to 300 μg/day. Despite this, TSH level remained high at 96.1 and freeT4 was 4.0. ...

Introduction: We present a case of Dunnigan Kobberling type of lipodystrophy in a young female.Case report: A 25-year-old woman presented with hirsuitism, secondary amenorrhoea, increase in neck size and reduction in breast size. On examination she had moon like facies, broad neck, small breasts and well defined male pattern musculature. Testosterone and lutenising hormone were marginally raised, serum alanine transminase was raised. Overnight dexamethas...

Objective: To test the hypothesis that poor adolescent diabetic control results in poor adult control.Methods: We conducted a retrospective case notes study involving 57 patients (M:F 30:27) in a teaching hospital. Patients who had diabetes atleast for a minimum period of 10 years were selected and their HbA1c when they were between 17 and 19 years of age were compared with the most recent HbA1c.The adolescent control was divided i...

Insulinoma is a tumour of the endocrine pancreas, usually benign, with an annual incidence of 1–2 new cases per million population. We describe a case of Insulinoma complicated by the simultaneous development of diabetes.A 72year old lady had episodes of funny turns and confusion following her meal. She had lost a stone in weight over 6–8 months. There was no history of sulphonylurea ingestion. Examination revealed low BMI and no evidence of ra...