Endocrine Abstracts

Aims: Within Imperial College Healthcare Trust, St Mary’s Hospital has a large one-stop shop thyroid service. On average, 700 encounters have been recorded per annum in the St Mary’s thyroid nurse-led service since its inception in June 2017. We aimed to critically evaluate the role of the specialist nurse within safe and robust monitoring clinical parameters, to determine the conditions managed in the nurse-led service and assess attendance rate.<p class="abstex...

Polycystic ovary syndrome (PCOS) is a multifactorial, complex endocrine disorder affecting a significant proportion of the global population. Hyperandrogenism is a key feature of PCOS patients. Aberrant secretion and/or action of gonadotropins have been implicated in PCOS, but, to date, we have only limited knowledge of how these factors may interact in the aetiology of PCOS. We hypothesised that excess androgens may cause aberrant gonadotropin activity and therefore sought to...

Case history: A 26-year-old lady presented with a two-week history of weakness associated with pins and needles affecting the lateral calf and dorsomedial aspect of her left foot. The patient denied any trauma or symptoms including weight loss. She had no drug allergies and was taking no regular medications. She had a vegan diet supplemented with multivitamins. Her past medical and family history was unremarkable. On examination, she had a narrow-based high-steppage-gait. Lowe...

The treatment of patients with carcinoid heart disease (CHD) presents substantial challenges due to the advanced multisystem nature of their disease. Intensive multidisciplinary collaboration and innovative techniques are often required in order to manage these patients. Here we describe two such cases from our institution. A 59-year old gentleman with metastatic NET and CHD was referred to our centre. Transoesophageal echocardiography demonstrated severe tricuspid regurgitati...

Introduction: Hypercalcaemia in Williams-Beuren syndrome (WBS) is usually mild and transient, but may be severe in about 5% of new presentations. Often some children will not respond well to traditional therapies.Case report: We describe three cases of acute hypercalcaemia and their management in a regional Paediatric unit. Case 1: A 16-month-old known WBS girl, presented with irritability, reduced feeding. Corrected serum calcium was 4.51 mmol/l. She wa...

Background: Accurate evaluation of growth is a key assessment of child health, in the UK use of a paper growth chart is currently standard practice. Our trust had a drive to become paper light thus there needed to be a way to store growth data electronically. Growth data is often incompletely documented. A previous review of children’s outpatient attendances at our hospital found that across medical, surgical and tertiary specialties only 33% of children had growth data d...

Introduction: Despite public health interventions, paediatric obesity in the UK is increasing, with almost one third overweight or obese. The direct cost of obesity to the NHS is estimated at 4.2 billion a year. The North-East has some of the highest rates of obesity in the country. A recent clinical practice guideline (March 2017) from European and US Endocrine societies aims to inform assessment, treatment and prevention of paediatric obesity.Aim: To e...

Introduction: Denosumab is a human monoclonal antibody against the receptor activator of nuclear factor-kB ligand, to reduce bone resorption by limiting maturation of osteoclasts. It has been approved for use in Scotland in patients with a bone mineral density (BMD) T-score of between −4 to 2.5 who are unable to take bisphosphonates. We aimed to analyze the effects of denosumab on BMD and fracture rate in a cohort of patients who have completed a 3-year cycle of...

Introduction: BONJ is a recognised complication of bisphosphonate treatment (both oral and intravenous). Data are sparse with the reported incidence of BONJ in the oral treatment of osteoporosis between 0.01% to 0.067% or alternatively described as 1.04 to 69 per 100,000 patient-years. This study aimed to estimate the incidence of BONJ in patients taking oral bisphosphonates as a treatment for osteoporosis.Methods: Forth Valley Hea...

Introduction: POEMS syndrome is a rare multisystem disorder characterised by polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma-proliferative disorder and skin changes among other features. We describe the course of the endocrine disease in the context of this paraneoplastic syndrome.Methods: Of the 60 patients with POEMS care in hospital, data are available for 43 patients who attended the Joint POEM...