Endocrine Abstracts

A 20-year-old gentleman with an established diagnosis of Chronic fatigue syndrome was admitted to hospital with palpitations and shortness of breath on exertion. He had been taking ‘healthy supplements’ for his ME for a year. On examination, he was noted to be tachycardic with a heart rate of 120–150 beats/minute. ECG confirmed sinus tachycardia. Further investigations revealed a free thyroxine (fT4) of 29.4 pmol/l and thyroid stimulating hormone (TSH...

History: A 27-year-old woman with a background of HIV presented to the GUM department with sudden onset of weight gain (approximately five stones over 3 months). She had been started on kaletra (Lopinavir with Ritonavir) for her HIV, about 11 months previously, while she was on fluticasone (seretide) for her asthma. Clinically, she had a cushingoid appearance with extensive purplish striae marks over her abdomen and arms. Her Seretide was stopped and changed to ventolin- due t...

Primary hyperparathyroidism (HPT) in pregnancy is an uncommon phenomenon, mostly occurring in the 2nd or 3rd trimester. HPT in pregnancy may cause complications affecting both the mother (renal stones, pancreatitis) and fetus (neonatal tetany, seizures, intra-uterine growth retardation and preterm labour). We report two recent cases that highlight the potential risks.Results: The patients, 37 and 35 years old at presentation respectively, both presented ...

Subclinical CS, mild hypercortisolism without overt clinical manifestations, is the most frequent (5–8%) hormonal abnormality detected in patients with secreting adrenal incidentalomas.Unclear clinical features and mild hypercortisolism make the diagnosis problematic, although laboratory criteria have recently been reviewed. In these cases, scintiscan is a central tool to define the adrenal functional activity.A 60-year-old ma...

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...

Primary hyperparathyroidism is a common endocrine disorder. Diagnosis is more frequently made where calcium testing forms part of routine screening bloods. The clinical profile has shifted from a symptomatic disorder with hypercalcaemic symptoms, kidney stones and overt bone disease towards a more asymptomatic state. The National Institutes of Health (NIH) have produced guidelines on diagnosis and management of primary hyperparathyroidism but no UK guidelines are in existence....

Introduction: In young patients with Primary hyperparathyroidism, parathyroidectomy is the treatment of choice. Transient hypocalcaemia is common complication of parathyroidectomy but rarely potentially life threatening hungry bone syndrome (HBS) can develop. HBS is a state of hypocalcaemia, hypophosphataemia and tetany without concomitant hypoparathyroidism, and is caused by massive calcium deposition to the bone. Resulting hypocalcaemia can be severe and prolonged, requiring...

Familial hypoparathyroidism is a rare condition. A family with seven affected individuals is described. Six sets of case notes were available for comparison. The most probable type of genetic transmission is autosomal dominant. There is also a family history of renal stones and ankylosing spondylitis.At diagnosis, adjusted calcium levels ranged between 1.77 and 1.92 mmol/L. PTH levels were either undetectable or in the low-normal range. Most cases were s...

A 50 year old lady undergoing elective surgery for pyloric stenosis secondary to chronic ulceration, was diagnosed with primary hyperparathyroidism (calcium 3 mmol/l), elevated parathyroid hormone (PTH). Following exploratory parathyroidectomy, left and right superior parathyroid adenomas were removed. 2 years later she re-presented with hypercalcaemia (Calcium 2.74 mmol/l, PTH 26.5 pmol/l (1.1–6.8 pmol/l)) and appeared Cushingoid. Investigations confirmed Cushing’s ...

We report a family with a novel heterozygous mutation of the menin gene. This gene encodes a tumor suppressor protein which is responsible for multiple endocrine neoplasia type 1. The index female patient presented with symptoms of mild gastric hyperacidity and recurrent kidney stones. Family history revealed, that the daughter, as well as two sisters of the index patient had operations for primary hyperparathyroidism (PHPT). Clinical studies in the index patient showed elevat...