Endocrine Abstracts

A 67 year old female presented with hypertension, oedema and cough. A CT scan of her abdomen showed an enlarged left adrenal gland. Urinary free cortisols were grossly elevated and low dose dexamethasone suppression testing confirmed Cushing’s Syndrome. 24 hour catecholamines were also elevated consistent with a diagnosis of phaeochromocytoma. ACTH levels were high (690 pg/ml) but pituitary MRI was normal. She was commenced on alpha and beta blockade in preparation for su...

Dr David Unwin MbChB FRCGP Our GP practice of 9500 people has suffered an eight-fold increase in the number of patients with T2D since 1986. In addition, those affected now develop this condition decades earlier than was the norm back in 1986. A situation replicated all over the developed world. Nationally there are 122,780 children and young adults under the age of 40 years with type 2 diabetes, 1,560 (around 1.3 per cent) are under the age of 19 years. In 2013 our practice d...

Paragangliomas are rare neuroendrocrine tumours arising from extra-adrenal paraganglia of the autonomic nervous system and excess catecholamine secretion is associated with higher cardiovascular morbidity and mortality. We present the case of a 56-year old male referred to our outpatient clinic with symptoms of sympathetic-hyperactivity, including excessive sweating, palpitations and diastolic hypertension (140/100 mmHg). He had undergone...

Paragangliomas are rare neuroendrocrine tumours arising from extra-adrenal paraganglia of the autonomic nervous system and excess catecholamine secretion is associated with higher cardiovascular morbidity and mortality. We present the case of a 56-year old male referred to our outpatient clinic with symptoms of sympathetic-hyperactivity, including excessive sweating, palpitations and diastolic hypertension (140/100 mmHg). He had undergone...

33 year old female who is 5 months pregnant, referred to Endocrinology clinic with TFT’s in keeping with sub clinical hyperthyroidism. Previously also had thyroid USS showing large 5 cm nodules both lobes, both indeterminate in appearance (U3) which preceded pregnancy. Symptomatic with sweating and palpitations. No family history of thyroid disease and no ‘red flag’ symptoms. Clinical examination showed palpable thyroid nodules with no evidence of thyrotoxicosis...

Polycystic ovary syndrome (PCOS) is an endocrinopathy affecting 5–10% of women. The PCOS symptomatology spectrum includes compromised fertility, dermatological conditions and metabolic dysregulation, the predominant cause of which is excess androgen production. PCOS is associated with increased risk of developing features of the metabolic syndrome which is exacerbated by the fact between 40 and 80% of PCOS diagnosed women are estimated to be obese. Achieving modest weight...

Athletes with type 1 diabetes need to be advised on the most appropriate diet to maximise their performance.I will review the recommendations stated in the 2010 Position Statement on Physical Activity and Exercise in Diabetes and to look at sports supplementation.Sports supplements can assist athletes to achieve improved performance. However, poor regulation of the supplements industry allows athletes to be bombarded with products ...

Adrenocortical cancer is a rare and heterogenous malignancy with incompletely understood pathogenesis and poor prognosis. Sometimes patients present with hormonal excess symptoms (e.g. virilization, Cushing’s syndrome) or local symptoms consistent with abdominal space-occupation (median tumor size at the time of diagnosis may be >10 cm). Three cases are presented to give an overview of how adrenocortical cancer is currently managed. Tumors typically appear inhomogenou...

A 36 M seen in endocrinology clinic October 2022 with 9/12 history of reduced testicular size and hypo gonadal symptoms. He has a past medical history of suicidal ideation and urinary incontinence. On review of previous GP records from 2003 he was seen for delayed puberty, although the patient denied this in clinic. There was no history of testicular trauma or infection and he denied any history of exogenous steroid or recreational drug use. There was no significant family his...

Background: HDL is a plasma lipid-protein complex of lipids and alphalipoproteins (apolipoproteins A-I and A-II). It is involved in reverse transport of cholesterol from peripheral tissue to liver, allowing cholesterol degradation. HDL cholesterol (HDL-C) levels are inversely associated with cardiovascular risk. HDL-C levels can be elevated due to genetic causes or drugs. We present a case where significantly raised HDL levels caused some concern at the outset.<p class="ab...