Endocrine Abstracts

Introduction: The 4th International Workshop on asymptomatic primary hyperparathyroidism (PHPT) has set criteria for surgical intervention and suggests that a percentage of patients can be managed conservatively. Imaging is indicated only pre-operatively to determine the optimal surgical approach.Patients and methods: We completed an audit on the use of Sestamibi, clinical and biochemical data in patients with PHPT.<...

Primary Hyperparathyroidism is one of the common endocrine disorders seen in an endocrine clinic. We retrospectively analysed patients referred with primary hyperparathyroidism over 1 yr (Oct 2013 - Sept 2014) and followed them over next 30 months. Patients with isolated secondary hyperparathyroidism were excluded. Few had secondary hyperparathyroidism in addition to primary hyperparathyroidism.50 patients with primary hyperparathy...

Adrenal insufficiency is an uncommon endocrine condition with an incidence of 4 cases per million. Common non-iatrogenic causes include autoimmunity, infections and infiltrations. We describe a case of acute adrenal insufficiency secondary to an unusual cause.A 77-year old female was admitted under the surgeons with abdominal pain and pyrexia. Abdominal ultrasonography showed large stones within a thickened gallbladder and a pr...

Case History: A 79 year old gentleman sustained a traumatic fracture of his left humerus in November 2016. Given his age and non-union of fracture, he was referred for a dual X-ray absorptiometry (DXA) scan in May 2017. This demonstrated markedly elevated bone mineral density (BMD) and subsequent investigation was performed.The patient has a past medical history of type 2 diabetes mellitus, hypertension, asthma and kidney stones. H...

We report a rare case of hyperthyroidism secondary to Graves’ disease which failed to respond to three consecutive therapeutic doses of radioactive iodine 131.This 62 year old gentleman with a history of ischaemic heart disease was first referred to endocrine services in September 2014 with classical symptomatic hyperthyroidism. He described fatigue, significant weight loss of 3.5 stones, sweating, palpitations and heat intolerance ove...

Autosomal dominant hypoparathyroidism (ADH) is caused by gain-of-function mutations in the calcium-sensing receptor (CaSR), increasing its sensitivity to extracellular calcium, suppressing PTH and resulting in hypocalcaemia. In contrast to idiopathic hypoparathyroidism, treatment to correct serum calcium results in high urine calcium excretion, causing nephrocalcinosis, stones and renal impairment. Unlike surgical hypoparathyroidism where calcium should be maintained, patients...

A 32-years-old lady was admitted with raised calcium. She had palpitation, sweating, 3 stones weight loss and neck swelling. She was diagnosed with Graves’ disease 5 months ago. Her mother had history of thyroid disease but no family history of hypercalcaemia. She had a small goitre and lid lag on examination. On admission, adjusted calcium was 3.04 mmol/l. PTH was < 0.5 pmol/l. Phosphate, vitamin-D, kidney functions, cortisol, myeloma screen and ACE levels ...

Introduction: Primary hyperparathyroidism (PHPT) is a commonly encountered endocrine pathology. Asymptomatic renal stones have been reported in 7-22% of patients. NICE guideline (NG132) published in May 2019 on PHPT recommends renal US in all patients. The value of renal ultrasound for all patients with PHPT has been debated. This audit aims to compare local practice to NICE guideline (NG132) and to see if a tailored approach for renal ultrasound would be safe, practical and e...

A 50 years old man was seen in the Endocrine clinic with elevated calcium (2.80 mmol/l, normal 2.20-2.60) and Parathyroid hormone (10.7 pmol/l, normal 1.6-6.9) levels. His medical background includes Alport Syndrome, Renal Allografts (1st 1990, 2nd 2000 and 3rd 03/11/2005), and Osteopenia on DEXA scan in February 2020. He did not have any renal stones in the past. There was no family history of hypercalcemia. He was on Vitamin D 1000 Units daily (Vitamin D 55 nmol/l, normal 50...

Background: Multiple endocrine neoplasia type 2 (MEN2) is a group of pleomorphic syndromes which infer a susceptibility to several endocrine conditions. The RET Val804Met mutation is classified as a moderate-risk mutation for familial medullary thyroid cancer (MTC), without the other components of MEN2 syndromes. However, here we describe a rare case of a gentleman with RET p.V804M, presenting with primary hyperparathyroidism (PHPT) and no evidence of MTC.<p class="abstext...