Endocrine Abstracts

Introduction: Obesity is known to be associated with hypogonadotropic hypogonadism. Hypogonadism is an established risk factor for cardio vascular disease and type 2 diabetes mellitus (T2DM). However there is little evidence on improvement in testosterone with bariatric surgery.Aim and methods: To asses changes in testosterone levels after bariatric surgery. Retrospective study on men undergoing bariatric surgery, and data collected pre and post surgery....

Background: Hypercortisol states present a diagnostic conundrum. Other conditions such as cyclical and subclinical Cushings pose additional challenges. We report a complex clinical presentation of thymoma with coexisting subclinical Cushing’s.Case report: A 65-year-old man presented to chest clinic with breathlessness and anterior mediastinal mass on CXR. CT scan demonstrated a 7.5 cm probable thymoma and bilateral adrenal masses of varying sizes up...

Background: Elevated TSH with raised free T4 (fT4) presents a diagnostic challenge. Symptomatically they vary across the spectrum of thyroid status. We report cases with these dilemmas.Case 1: Seventy four year old was referred with 5 years of TSH ranging between 4.9–7.9 mIU/l (0.2–4.0), fT4 18.5–27 pmol/l (9.0–19) and free T3 (fT3) 4.5–12 pmol/l (2.5–5.7). Thyroid perox...

Background: Diabetic ketoacidosis (DKA) remains the leading cause of morbidity and mortality in children with type 1 diabetes. In the past few years, both the International Society for Paediatric and Adolescent Diabetes (ISPAD) and the British Society for Paediatric Endocrinology and Diabetes (BSPED) have recommended key changes in the management of DKA. These changes incorporate new evidence to reduce the incidence of cerebral oedema and the increased use of insulin pumps.</p...

Introduction: Guidance on the management of diabetic ketoacidosis (DKA) has recently been updated in an effort to reduce the risk of complications, in particular, cerebral oedema. However, differences in recommendations for children and adults persist making the care of teenagers with DKA confusing and potentially hazardous.Aims: To compare the management of DKA in teenage patients in paediatric and adult care settings in the context of the latest nation...

Introduction: The Paediatric Oncology Late Effects Clinic in Leicester was established in 1999, in order to monitor cancer survivors for the development of secondary co-morbidity, including that relating to endocrinopathy from treatment for the underlying oncological diseases.Aim: As a retrospective audit of our clinical service against the current existing guidelines (UKCSSG, SIGN), specifically to monitor the endocrine standards with respect to axiolog...

Fourth-two years old female patient was diagnosed with carcinoma left breast in 2003. She had mastectomy of left breast and axillary clearance followed by adjuvant radiotherapy and chemotherapy. Histology showed ER positive. She was commenced on anastrozole. She suffered from back pain in 2005. Investigations revealed she had spinal metastases as well as left ureteric stone and hydronephrosis of left kidney. She had a left ureteric stent and her back pain was relived. USG kidn...

Case History: 54 year old man was admitted with 3 week history of dizziness and feeling unsteady on feet. He also had persistent central abdominal pain with no vomiting or diarrhoea. On examination, his lying and standing BP were 117/75 and 73/43 mm Hg respectively. He had tenderness over the right hypochondrium and right lumbar region. His initial investigations showed sodium – 128 mmol/L and potassium – 4.2 mmol/L. Short synacthen test was arranged and the cortisol...

Swyer-James syndrome or 46, XY female is an unusual condition, characterized by pure gonadal dysgenesis in a phenotypic female patient. Successful pregnancy is even rarer as these patients will require oocyte donation program. We present a 39 year old lady with 46, XY pure gonadal dysgenesis who had a successful pregnancy through in-vitro fertilization by oocyte donation.At her original presentation in 1984, our patient’s main complaint was primary ...

BACKGROUNDAngina and Myocardial infarction have been reported in hyperthyroidism. Intense coronary artery spasm can be life threatening as it can lead to ventricular fibrillation and haemodynamic instability as reported in this patient.CASE HISTORYA 45-year-old lady was admitted with a history of head aches, palpitations, diarrhoea and weight loss. She was subsequently found to have thyrotoxicosis with the th...