Endocrine Abstracts

A 48-year-old woman presented to her GP with polyuria and proximal muscle weakness. She was found to have newly developed hypertension at 180/96 and her serum potassium was 2.7 mmol/l. Lisinopril 40 mg od and Slow-K 1 tablet bd were started and she was referred for further investigation.On clinic review blood pressure was 188/110 supine and 190/110 standing. Serum sodium was 147 mmol/l, potassium 3.7 mmol/l and total bicarbonate 29 mmol/l. Her Lisinopril...

A 51-year-old woman with no significant past medical history presented with left flank pain, accelerated hypertension, progressive deterioration in renal function and left sided pleuritic chest pain. CTPA revealed pulmonary oedema and left adrenal haemorrhage. Urinary catecholamines were marginally elevated (24 h Urinary Metadrenalines 7.58 μmol/24 h) raising the possibility of an underlying phaeochromocytoma. Short synacthen test showed a sub-optimal response (0 min cort...

Aims: Our aim was to explore factors related to the acute presentation of diabetic keto-acidosis (DKA) in patients with Type 2 diabetes mellitus (T2D), and to identify any predictors for severity of DKA in T2D.Methods: This was a retrospective study based on acute medical admissions presenting to the Royal Berkshire Hospital during 2008. Criteria for inclusion included a confirmed diagnosis of DKA (defined by a plasma glucose level >11.1 mmol/l, keto...

In October 2006 a 53-year-old, non-smoking woman presented with ectopic Cushings from a small cell, undifferentiated carcinoma (Grade 3 neuroendocrine) from a 10 mm tumour at the left lung hilum (Cortisol: 09:00 a.m. 720 nmol/l; 24.00 mm 742 nmol/l. ACTH 114 ng/l). Four years before she had sustained a myocardial infarction, with atrial fibrillation, and was found to have Graves’ disease, being treated initially with carbimazole then radioactive iodine, becoming hypothyro...

Context: Prolactinomas are the most common functioning pituitary adenomas & it is recognised that gender has an influence on presentation and management of this condition.Objective: To examine the effects of gender on presentation and response to treatment in a large cohort of adults with confirmed prolactinoma (MRI performed and macroprolactin excluded).Design & patients: This retrospective cohort study design used an elec...

Objective: Our objective was to examine recurrence of hyperprolactinaemia following discontinuation of dopamine agonist (DA) therapy in patients with macroprolactinoma who have had treatment for 3–15 years.Methods: We identified retrospectively adult patients (n=15) attending OCDEM (Churchill Hospital, Oxford, UK) with a confirmed diagnosis of macroprolactinoma (established during the last 25 years), who had been treated with DA therapy for a...

Differentiated thyroid cancers function less well than normal thyroid tissue but continue to secrete thyroglobulin (Tg) which can be iodinated to form thyroxine (T4) and triiodothyroxine (T3). Functioning metastases causing thyrotoxicosis are rare. The majority of reported cases have large volume, metastatic follicular tumours. A significant proportion develop T3 toxicosis with normal T4 levels. T3 toxicosis is often mild....

A 19-year-old, female of West African descent presented with a 5 months history of thyrotoxicosis. The GP had commenced carbimazole. She had continuing clinical and biochemical thyrotoxicosis TSH <0.01 (0.3–5.5 mU/l), FT4 68.0 (9–20 pmol/l) and FT3 18.9 (3.4–5.6 pmol/l). Thyroid antibodies were present at elevated titre and technetium uptake scanning showed toxic diffuse hyperplasia with an uptake function of 37%, confirming Graves&#146...

Iodine (I) and selenium (Se) are two essential trace elements for regular thyroid gland functioning and thyroid hormone metabolism. Most Europeans are only marginally supplied with both elements through their daily nutrition. The mammalian organism has developed efficient and highly complex mechanisms to control I and Se uptake, metabolism and recycling. The thyroid gland is equipped with the necessary transporters and metabolizing enzymes for I uptake and bioconversion into t...

We report a rare case of 37 years female of Greek and Irish extraction with a history of thalassemia trait, who presented with generalised weakness and severe loin and pelvic pain 9 days post vaginal hysterectomy and 3 days after hospital discharge. After readmission, she developed mild pyrexia (37.5°C), hypotension, mild hyponatraemia with plasma sodium which fell from 138 to 131 mM and early signs of acute respiratory distress syndrome. A Short Synacthen test was perfor...