Endocrine Abstracts

Case history: A 73-year-old female with a background of hypertension presented to the acute physicians with a 4 month history of progressive headaches. The headaches did not have any ‘red flag’ features. A non-contrast CT scan revealed an intrasellar lesion. She was referred to endocrinology for further management. Her history did not suggest hypopituitarism, Cushing syndrome or acromegaly. There were no visual field defects and her eye movements were normal.<p c...

A 34-year-old was referred for a second opinion regarding his incidental mild hypercalcemia ranging between 2.56 mmol/l and 2.88 mmol/l, with a corresponding PTH ranging between of 3.3 pmol/l and 6.8 pmol/l (laboratory reference range 1.3-9.3 pmol/l). He did not have a history of renal calculi or fractures. He reported chronic recurrent diarrhoea, weight loss, low mood and chronic headache. There was no known family history of calcium disorders. His examination did not reveal ...

A 68-year-old male presented with fatigue and acute onset polyuria and polydipsia. There was no history of headaches, visual symptoms, previous cranial radiations, chemotherapy or CNS infections. Investigations revealed normal fasting glucose, urea, creatinine, liver functions and electrolytes including calcium. Further workup including pituitary profile, paired osmolalities and water deprivation test confirmed hypopituitarism and cranial diabetes insipidus (Table 1). The unde...

Introduction: Adrenal incidentalomas (AIs) are increasingly being identified due to more frequent use of cross-sectional imaging modalities. Recent studies reported AIs being identified in 7.3% of abdominal CT imaging. Most adrenal incidentalomas are adenomas that may have secretory activity.Case Report: An 80-year-old lady presented to our Emergency department with one week’s history of worsening right eye bulging and discomfort. She was found to h...

Section 1: Case history: A 69-year-old female with a past history of treated hypertension and Graves’ disease presented to the emergency department with a two-day history of headaches, vomiting, confusion and difficulty swallowing following a recent holiday in Spain. She had clinical meningism and a diagnosis of meningitis was made.Section 2: Investigations: After an initial CT scan of her head was reported as unremarkable, a lumbar puncture was per...

61-year-old previously fit and healthy female presented with one-week history of confusion and altered consciousness. There was no history of fever, headache or limb weakness. She was dehydrated, Glasgow Coma Scale score was 11/15, pupils were equal and reactive to light bilaterally and rest of examination was unremarkable. Initial investigations are outlines in Table 1. X-ray-chest showed mediastinal lymphadenopathy and CT head was unremarkable. She was initially treated for ...

Case history: A 44 year old black African woman was referred to the endocrinology clinic for investigation of abnormal thyroid function tests. She had initially presented with palpitations and sweats. She had no significant past medical history and was not taking any prescribed medications or over the counter preparations. On examination, she was clinically euthyroid and did not have any abnormal findings of note.Investigations: Biochemical investigation...

A 64-year-old woman presented acutely with dry cough, difficulty in eating, diarrhoea and weight loss. Her past medical history included cervical carcinoma in situ treated with laser therapy. She was found to be hypercalcaemic, with a corrected calcium of 2.84 mmol/l. During admission, the calcium ranged between 2.8-3.87 mmol/l. The PTH ranged between 0.2-0.4 pmol/l (1.3-9.3 pmol/l). She had raised inflammatory markers and deranged liver function tests. On review, she...

Case history: A 28-year-old female was investigated for hypocalcaemia. Her calcium level was checked because her mother was found to be hypocalcaemic post thyroidectomy for recurrence of Graves disease. Further detailed history taking revealed that the patient’s grandmother often complained of hand cramps on kneading dough. The patient’s aunt was believed to have a parathyroid disorder; no further details were available. On further investigation, it was apparent that...

A 50 year old male presented with left visual field loss, afferent pupillary defect and reduced libido in 1999. Initial pituitary profile showed prolactin 130 000 mu/l (55.4–276), and testosterone was 5 nmol/l (10–27.6). MRI pituitary showed giant pituitary macroadenoma compressing chiasm. He was started on Cabergoline with subsequent improvement in visual fields, prolactin levels and size of adenoma on subsequent MRI. His disease remained stable on ...