Endocrine Abstracts

A 73-year-old lady with a history of type two diabetes since 1993, mastectomy for carcinoma left breast in 2000, primary hypothyroidism, and hypertension was referred to the local hospital in view of poor glycaemic control in July 2001. Her medications included Thyroxine, Atenolol, and Tamoxifen, Frusemide, Gliclazide 160 mg BD and Pioglitazone 30 mg. At the time of referral her weight was 68.5 kg, (BMI 23.7), HbA1c 10.2%. She was started on Humalog mix 25 BD. In 2003 her weig...

Background: The use of opioids in non-cancer patients has increased dramatically over the past few years. The most common endocrine dysfunction with opioid use is hypogonadism, but it has been reported in a small number of cases that adrenal insufficiency and adult growth hormone deficiency can also occur.Clinical case: A 39 year old male presented with general fatigue, loss of libido and sweating for about six mont...

Background: The use of opioids in non-cancer patients has increased dramatically over the past few years. The most common endocrine dysfunction with opioid use is hypogonadism, but it has been reported in a small number of cases that adrenal insufficiency and adult growth hormone deficiency can also occur.Clinical case: A 39 year old male presented with general fatigue, loss of libido and sweating for about six mont...

Introduction: Despite the commonality of hyponatraemia in everyday clinical medicine it is often a poorly management condition in acute medical patients. A European guideline for diagnosis and management was published in 2014 to address such problems.Aims: To assess the standard of management of patients with hyponatraemia admitted to the medical departments in a rural District General Hospital. To improve investigation, diagnosis, and management of thes...

Introduction: Unilateral adrenalectomy is an effective treatment for aldosterone producing adenoma. However, after adrenalectomy, suppression of the contralateral zona glomerolura (ZG) function can lead to transient hypotension & hyperkalaemia. We present a protracted case of post-operative adrenalectomy related hypoaldosteronism.Case: A 54-year-old hypertensive male with confirmed primary hyperaldoseronism (PRA<0.1 nm/h, aldosterone 1050 pmol/l;...

Resistance to thyroid hormone is a dominantly inherited condition of impaired tissue responsiveness to the action of thyroid hormone. Thyroid hormone levels are elevated with failure to suppress TSH.The presentation is highly variable. In individuals with generalized resistance to thyroid hormone (GRTH) appear to have eumetabolic state with compensatory high thyroid hormone levels. In contrast, those who appear to have hyper metabolic features but may have similar thyroid horm...

Background: The plurihormonal pituitary adenomas represent 10-15% of all functioning pituitary adenoma. Mixed Growth hormone and prolactin secreting adenomas are the commonest one, approximately 5% of surgically removed adenoma. Other hormonal mixture of adenoma may occur, but very rare. We present a rare case of co-secreting TSH and GH adenoma. Clinical Case: A 45 year old gentleman, generally fit and well, presented with 3 years history of blurred visi...

Introduction: Primary amenorrhea is usually caused by either gonadal or anatomical abnormalities. Turner’s syndrome (TS) is the result of partial or complete absence of X chromosome in females with an incidence of 1 in 2500 live female births. Mullerian agenesis due to Mayer-Rokitansky-Hauser syndrome (M-R-K-H syndrome; embryonic underdevelopment of the vagina with variable uterine development) has an incidence of 1 in 5000 females and can be mistakenly diagnosed in patie...

Section 1: Case History: A 45-year-old gentleman attended the emergency department in December 2016 with an episode of stupor, confusion and lethargy with blood glucose of 1.8 mmol/l. He recovered after administration of IV glucose. He had ’funny spells’ for a year prior to the event. He had a history of childhood asthma and was not on any regular medications. There were no significant findings in the clinical examination and no relevant family history. <p class=...

Introduction: Primary hyperparathyroidism is usually caused by a parathyroid adenoma (80-85%), occasionally by primary parathyroid hyperplasia (10-15%), and rarely by atypical parathyroid tumor (APT) or carcinoma (<1%). APT reflects parathyroid neoplasm of uncertain malignant potential which poses a challenge for differential diagnosis with parathyroid carcinomas. Most patients exhibit strong symptomatology of hypercalcemia at presentation shared with the benign causes of ...