Endocrine Abstracts

Background: Although early studies with IPSS reported a diagnostic sensitivity and specificity approaching 100%, additional experience has revealed a false negative rate of 1–10%. Previous studies have suggested that the measurement of other anterior pituitary hormones may be useful as a guide to the effectiveness of cannulation and to improve diagnostic accuracy.Method: In this retrospective cohort study, we reviewed all patients who had undergone ...

Case history: 58 year old man presented with collapse secondary to profuse water diarrhoea. He had severe AKI, hypokalaemia, metabolic acidosis, hyponatraemia and hypercalcaemia. He had fluid and electrolyte replacement he in ICU, but profuse diarrhoea persisted and with it, was in hypotension and delerium. He had been having progressive diarrhoea and weight loss for 2 years while he was in South Africa.Investigations: Upper and lower GI endoscopies had ...

A 25-year lady was referred to GSTT for further management of thyrotoxicosis as she had relocated to London. The patient developed thyrotoxicosis during her pregnancy at the age of 23. During her pregnancy, she had significant weight loss. Her thyroid function test in September 2020 showed TSH 0.04 mU/lwith FT4 of 24.1 pmo/land TSH receptor antibody of 1.35 U/l. Hence she was started on propylthiouracil (PTU) during pregnancy. PTU was titrated down based on biochemical respons...

Introduction: Thyroid hormone resistance due to a TRα mutation is rare and only recently described. We report a case of primary hyperparathyroidism in an adult patient with a known TRα mutation.Case presentation: A 60 year old female was referred with hypercalcaemia and hyperparathyroidism that persisted despite correction of vitamin D deficiency. Parathyroid hormone levels continued to be elevated or inappropriately normal with hyper- or normo...

Case history: This 27 year female was first seen at GSTT in 2012, having had treatment for acromegaly due to a presumed GH-secreting adenoma in 2007 (Trans-sphenoidal surgery × 2, EBRT (2007), pegvisomant (2007-2012 (discontinued due to adverse effects)), & GammaKnife SRS (2011). GH and IGF-1 remained elevated and further treatment with pegvisomant/ SSA was declined. Abnormal bone growth with jaw and skull asymmetry was evident from age 10 years and final height was 1...

Continouos subcutaneous hydrocortisone infusion (CSHI) is a novo treatment for adrenal insufficieny. This treatment aim to mimic body circadian rhythm by providing a continouos slow infusion subcutanously.We summarise our experience with 5 patients: 1 with primary adrenal insufficiency and 4 with secondary adrenal insufficiency. There are 1 male and 4 females with a mean age 31. All these patients were self referred and have tried ...

Continouos subcutaneous hydrocortisone infusion (CSHI) is a novo treatment for adrenal insufficieny. This treatment aim to mimic body circadian rhythm by providing a continouos slow infusion subcutanously.We summarise our experience with 5 patients: 1 with primary adrenal insufficiency and 4 with secondary adrenal insufficiency. There are 1 male and 4 females with a mean age 31. All these patients were self referred and have tried ...

In 2022, a 63 year old woman was referred for assessment of a six month history of gastro-oesophageal reflux symptoms and dysphagia. Upper gastrointestinal (GI) endoscopy was normal apart from mild reflux oesophagitis. A computerized tomography (CT) scan demonstrated a 2 cm nodule medial to the caudate lobe of the liver, a 1.5 cm nodule in the right lung base and two further sub cm nodules in the right lung lobe. In terms of background, the patient had a benign breast lump und...

A 31-year-old man originally from Ukraine attended the clinic having been started on Carbimazole 20 mg by his GP. His symptoms included intermittent palpitations, sweating and poor sleep and they had improved since starting anti-thyroid therapy. He was originally diagnosed with thyrotoxicosis in Germany in 1999 but was not treated and he re-presented in 2005. This time he was started on Carbimazole but stopped treatment on his own accord after a month because his symptoms impr...

A 60 year old lady was diagnosed with thyrotoxicosis in 1985 (aged 28) five months postpartum. She underwent partial thyroidectomy in 1990 (age 32). Thyroid tests remained abnormal and in 1992, she underwent radio-iodine treatment requiring post-treatment. She remained under endocrine supervision and the TSH was found to be persistently elevated with normal free thyroid hormone levels (whilst on Levothyroxine). Issue with compliance and assay interference were considered. She ...