Endocrine Abstracts

History: A 36 year old gentleman was referred to the endocrine clinic with symptoms of fatigue, absent libido and erectile dysfunction. He had a previous history of pulmonary sarcoidosis in 2000 and he was taking no medications. Examination revealed a known Right sided Horner’s syndrome and no other abnormality.Investigations: Testosterone 1.8 nmol/l, FSH and LH<0.5, Prolactin 798 mU/l, Cortisol 507 nmol/l, ACE 67 (47–60 IU/l), CSF protein ...

67-year-old man re-attended A&E following minor head injury with disproportional symptoms of dizziness on sitting upright, vomiting and neck pain. He is also complaining of nasal blockage for past 1 year with anosmia and occasional yellow rhinorrhoea. On examination he has mild neck tenderness and cranial nerves were intact. Nasopharyncoscopy revealed fullness of posterior nasal space.Head CT was performed revealing extensive soft tissue tumour appea...

Introduction: Cushing’s syndrome is rare disease with annual incidence 2/ million. It carries a high mortality rate if untreated. ACTH independent Cushing’s with Adrenal adenoma is responsible for 10% of cases. This is a case of a young gentleman with back pain, vertebral fracture, in presence of left adrenal incidentaloma, normal MRI pituitary, and hormonal profile indicative of possible non-detectable central pituitary lesion, diagnosis of likely adrenal Cushing&#1...

Aim: To find out all Acromegalic patients above the age of 40 years had their colonoscopic screening or not.Reason for colonoscopy screening: There is 13 to 14 fold increased risk of colorectal cancer in Acromegaly patients and 2.5 fold increase in mortality from Colonic cancer.Standards: i) Patientts with acromegaly should be offered regular colonoscopy from the age of 40 years.ii) ...

A 75-year-old man presented to Emergency department with fever and 3 episodes of tonic clonic seizures. He had recent ear infection. He was intubated and ventilated and taken to ICU.He had CT head which was normal. Lumbar puncture results were consistent with Pneumococcal meningitis. He was treated with appropriate antibiotics.During recovery he had persistent hyponatremia. He was reviewed by Endocrine team and his TFT, cortisol an...

Introduction: The ectopic ACTH syndrome accounts for 12% of patients with Cushing’s syndrome. Its diagnosis and treatment remains a challenge. This especially true in patients with ectopic ACTH production.Case: We report the case of a 41-year-old man who presented with progressive muscle weakness in his arms and legs. He was found to be borderline hypertensive BP 145/92, cushingoid plethoric rounded face and mild proximal muscular weakness. His init...

Seventy six year old man presented with sudden onset headache for 3 days. He was seen by the GP and treated for migraine. But no improvement in his headache and he developed drooping of left eyelid and blurring of vision. No other neurological symptom.On examination left ptosis with normal visual fields to confrontation method. Initial differential diagnosis was isolated 3rd nerve palsy probably due to posterior communicating artery aneurysm. He was on a...

Sixty seven year old gentleman presented to eye clinic with blurring of vision in the left eye for 2 weeks. Patient was seen by Ophthalmologist and discharged home. Presented 3 weeks later with headache and blurring of vision. On examination no perception to light in the left eye and bitemporal hemianopia.His past history includes carcinoma prostate, diagnosed a year ago and had surgery and Radiotherapy. His recent PSA was normal. Bones scan showed no ev...

Multiple endocrine neoplasia 1 (MEN-1) is an inherited autosomal dominant tumour syndrome affecting mainly the parathyroid gland, pituitary and pancreas. Genetic defect appears to be deletion mutation of MEN1 gene coding for tumour suppression. We describe a case of MEN1 mosaic mutation never reported in the literature.The index case presented aged 52 in 1985 with headaches and dizziness when hypercalcemia of 3.2 mmol/l was noted. Past medical history in...