Endocrine Abstracts

A 24-year-old Pakistani woman presented one day after returning from a 6-week holiday in Pakistan with a 3-day history of generalised weakness, difficulty in walking and left flank pain. She was known to have mixed connective tissue disease (MCTD). Clinically she was pyrexial and had generalised muscular weakness (power 3/5), and hypotonia. Biochemically, she was found to have hypokalaemia (1.8 mmol/l), raised serum urea (8.1 mmol/l), and creatinine (160 μmol/l), high ESR...

Background: Obesity levels and the demand for obesity services are increasing. Those with morbid obesity require specialist care and consideration for bariatric surgery. Based on recent figures and NICE guidelines, at least 35 000 individuals in Birmingham alone may be suitable for surgery. Numbers currently assessed are limited due to lack of resource and expertise. This audit reviewed baseline characteristics of patients referred for specialist obesity and bariatric services...

Hypomagnesaemia can cause Hypocalcaemia as magnesium interferes with parathyroid hormone action and secretion. It also causes hypokalemia due to defective membrane ATPase or urinary potassium loss. We present two patients who were admitted to our hospital with symptoms and signs of hypocalcaemia secondary to drug-induced hypomagnesaemia and describe the lessons learned.Patient 1: A 46 year-old lady presented with “pins and needles” and muscle c...

Aim: This study was aimed to assess the need for multiple cortisol samples in ruling out adrenal insufficiency by standard dose Short Synacthen Tests (SST) and Low Dose Short Synacthen Tests (LDSST).Method: We assessed the lab results of 767 patients who attended Metabolic Unit of a University Hospital in the UK from 1999 to 2006 for assessment of adrenal reserve. In LDSST, serum cortisol was measured at 0, 30 and 40 min after administration of 1 mcg of ...

Prolactinomas are the most common pituitary adenomas. The treatment is primarily medical with dopamine agonists. The improvements in prolactin levels are accompanied by reduction in the tumour size in the majority of cases. We report a patient with a macroprolactinoma whose tumour enlarged despite achieving normal prolactin levels.A 55-year-old gentleman was referred to the ophthalmologist with worsening vision in the left eye. Clinical examination revea...

We report of a 71-year-old gentleman first diagnosed with acromegaly in 1981. He was initially treated with hypophysectomy and radiotherapy and subsequently bromocriptine therapy; requiring increments in the dose over the next ten-years (1981–1991) by which time he remained on maintenance dose of 10mgs thrice-daily. Bromocriptine was tolerated well and the patient had no side effects. Treatment was weaned off due to improvement in patient’s symptoms and growth hormon...

Hirsutism affects 8% of women and forms an important reason for referral to the endocrine services in patients with polycystic ovarian syndrome (PCOS). Although antiandrogens are the mainstay in treatment, one needs to bear in mind that they are not without undesirable side effects.We present the case of a 37-year old woman, diagnosed with PCOS based on menstrual irregularities and typical ultrasound appearances of her ovaries. Her main concerns were hir...

Aim: To evaluate local management of thyroid nodules in comparison with the British Thyroid Association guidelines.Methods: All patients who had fine needle aspiration cytology (FNAC) for a thyroid nodule in 2004 and 2005 were included. Data collected included: patients’ age, gender, thyroid status, FNA Cytology (including repeats) and THY classification, surgical intervention and histology (if applicable).Results: 97 patients...

Polycystic ovarian syndrome (PCOS) is a common disorder affecting women of childbearing age. The clinical triad of PCOS includes: hirsuitism, oligo/amenorrhoea and ultrasonographic appearances of PCOS. However, this triad could occur in other disorders such as late onset congenital adrenal hyperplasia (CAH). Although CAH is mainly diagnosed in childhood, it could occur in adults. In this abstract we describe a patient who presented with features of PCOS, the final diagnosis, h...

Once daily Thyroxine is the treatment of choice for hypothyroidism. The dose of Thyroxine needed varies with a mean of 1.6 mcg/kg bodyweight a day. The most common cause for requiring larger doses is non-compliance although other causes such as malabsorption and drugs should be excluded. In this abstract we describe two patients with hypothyroidism that required large doses of thyroxine secondary to poor compliance in which supervised once weekly thyroxine therap...