Endocrine Abstracts

We report a 38 years old male who was referred to the endocrine clinic with 3 months history lethargy, lack of libido and reduced shaving frequency. He was previously fit and well with no past medical history however he and his wife has been trying for pregnancy for 2 years. He didn’t smoke, has no history of opioids use and drink 10 units of alcohol a week. His investigation showed panhypopiturism with profound low serum testosterone of <0.5 nmol/l (8.33–30.19),...

There are limited morbidity data regarding patients with adrenal insufficiency. We undertook a retrospective study to examine the aetiology and frequency of emergency hospital admissions. We identified 69 patients receiving hydrocortisone replacement for adrenal insufficiency. 50 medical records were obtained; 20 patients had primary adrenal failure (including CAH) and 30 patients had ACTH deficiency. All emergency admissions that occurred within the last 10 years were reviewe...

The frequent use of brain and head MRI/CT has lead to an increase in the number of incidental pituitary lesions reported, so called pituitary ‘incidentalomas’. Such lesions require endocrine evaluation of pituitary function and radiological follow up. We performed a retrospective study to examine the source of these referrals, size of the incidentalomas, frequency of pituitary dysfunction and changes during follow-up. We performed a search of the departmental endocri...

Primary pigmented nodular adrenocortical disease (PPNAD) is a rare cause of ACTH independent adrenal Cushing’s syndrome. A 32-year-old female with atrial myxomas was found to have Carney’s complex (PRKAR1A mutation negative). Screening showed biochemical Cushing’s syndrome (24 h urine free cortisol 918 nmol – nr 100–400) and the characteristic paradoxical increase in UFC during the 48 h dexamethasone suppression test was confirmed: 24 h UFC pre-dex 340...

69-year-old male with background of hypertension and dyslipidaemia was admitted to ENT with a food bolus obstruction. CXR on admission revealed a well-defined mass in the right lower lobe consistent with lung cancer. Oesophagoscopy revealed a narrowing level secondary to external compression. A staging CT of chest and abdomen confirmed a mass on the right base invading the main right lower lobe bronchus. Incidentally there was an 8 cm infra renal abdominal aortic aneurysm. The...

Background: Endocrinology, taught in Year 2 of the Edinburgh undergraduate MBChB curriculum to approximately 200 medical students, can present a complex challenge and a test of engagement. Core biomedical curriculum content is delivered as large group teaching (lectures) and then revisited in smaller groups (clinical-cased based tutorials, PBL) designed to integrate learning by applying basic knowledge in a clinical context. PBL first implemented in the 1960s at McMaster Unive...

Case history: A 45-year-old female with a background of depression presented with asthma exacerbation. She was taking paroxetine and mirtazapine for depression. Over the preceding six months the patient’s asthma control had deteriorated, resulting in overuse of inhaled beclometasone. On questioning, the patient reported a four stone weight gain in four months with generalised weakness, dizziness and fatigue during simple activities. On examination, the patient appeared ov...

Diabetes Mellitus is a chronic disease characterised by hyperglycaemia due to peripheral insulin resistance and/or insulin deficiency. This may be due to a decline in viable pancreatic β-cells number or β-cell dysfunction leading to impaired nutrient-induced insulin secretion. The most probable causes of these β-cell effects are exposure to elevated levels of inflammatory cytokines, glucose and free fatty acids. There are many synthetic and herbal drugs availabl...

Background: Untreated hypothyroidism may be associated with cutaneous signs including coarse, dry skin and hair loss. Myxoedema (also known as thyroid dermopathy) is usually associated with Graves’ thyrotoxicosis but has been reported in patients with hypothyroidism. We describe an unusual skin disorder in a patient with autoimmune hypothyroidism, initially misdiagnosed as myxoedema.Case: A 41-year-old female with an extensive medical history includ...

It is important to identify whether benign adrenal incidentalomas are hormonally active. Traditionally, investigations were arranged during the first medical consultation and relied heavily on the patient remembering a considerable number of instructions. The patient was required to collect urine bottles from pathology, a prescription from pharmacy and perform multiple tests including renin, which was often incorrectly performed in outpatients. Due to the cumbersome nature of ...