Endocrine Abstracts

Section 1: Case History: A 28 year old female initially presented to Endocrinology in 2020 with hirsutism and irregular menstruation but reassuring biochemistry. In 2022, she was referred to Gastroenterology with weight loss, vomiting and dyspepsia and found to have severe hyperprolactinaemia. Past medical history included anxiety/depression. Current medication was esomeprazole 40mg OD and mebeverine 135mg TDS. Cyclizine 50mg TDS had previously been prescribed, followed by dom...

A 47-year-old Caucasian gentleman was diagnosed with diabetes mellitus in September 2019. He presented with blood glucose 29.5 mmol/l and negative ketones in December 2020 and was treated with variable rate insulin infusion. He had short stature with height of 161 cm and weight 53.5 kg (BMI 20). There was mild weakness of quadriceps (4/5). Laboratory tests revealed high lactate (5.38 mmol/l) and HBA1c (70 mmol/mol), reduced eGFR (47 ml/min) and negative antibody. He had gradua...

Polyglandular autoimmune syndrome (PAS) is characterised by the coexistence of two or more autoimmune mediated disorders. While the pathophysiology remains poorly understood, environmental triggers and genetic susceptibility are thought to contribute to the dysregulated immune response. PAS has been classified into three main subgroups: Type 1 is seen in the paediatric population while types 2 and 3 are found in adults with autoimmune thyroid disease and insulin-requiring diab...

A 31 year old female patient initially presented with a two month history of unintentional weight loss. Past medical history included multiple sclerosis, for which she had last received alemtuzumab immunotherapy five months previously. Thyroid function tests (TFTs) demonstrated hyperthyroidism, with Thyroid Stimulating Immunoglobulins (TSI) 5.71 iu/l(NR: <0.56). She was diagnosed with Graves’ disease, possibly induced by alemtuzumab, and commenced on carbimazole. She ...

Introduction: Gigantomastia is a rare condition characterised by excessive benign breast tissue growth that is thought to be a result of elevated physiological levels of circulating hormones (e.g. pregnancy), or an increased sensitivity of the breast tissue to such hormones. Isolated reports describe some medical conditions as precipitants (e.g. systemic lupus erythematosus (SLE)) or drugs (e.g. cyclosporine). Many will proceed to surgical intervention to improve physical and/...

Tolvaptan is an ADH antagonist licensed for the treatment of the syndrome of inappropriate ADH secretion (SIADH). We describe the case of a patient with severe symptoms due to refractory SIADH who was successfully treated with tolvaptan. A 35-year old patient developed a chordoma involving the pituitary gland and optic chiasm and was treated with surgery, radiotherapy and gamma knife therapy. After several years, she developed recurrent, severe, symptomatic hyponatraemia due t...

A 58-year-old female presented to Urology clinic after an abdominal ultrasound revealed a right sided mass. She had a 9 year history of hypertension which had been difficult to control despite treatment with six agents. She also had a history of Type 2 Diabetes Mellitus and Hyperlipidaemia. CT Thorax/Abdomen/Pelvis reported a 20 cm right renal mass with areas of calcification and following MDT discussion the diagnosis of renal cell carcinoma was made. An open right radical nep...

A 54-year-old gentleman presented to his GP in July 2019 with significant weight loss, polyuria and nocturia for two to three months. His HbA1c was 78 mmol/mol. He was diagnosed with diabetes and started on Metformin 500 mg BD. Upon consultant review in September 2019, he reported a 26 kg weight loss over the preceding four years, much of which was apparently intentional, and right abdominal discomfort. His paternal grandmother died of pancreatic cancer, as did his paternal au...

We describe the case of a 70-year-old lady presenting with marked, symptomatic hypercalcaemia.Past medical history was of insulin-treated Type 2 Diabetes, macrovascular disease and chronic renal impairment.On admission, corrected calcium was noted to be 3.53 mmol/l with a paired PTH within normal range (4.3 pmol/l, range 1.6–9.3). Further questioning revealed a history of weight loss but no other clinical features specifically...

Background: Clinically relevant pituitary adenomas (Pit PA) affect approximately 1:1200 of the general population, and may manifest with hormone hypersecretion, hypopituitarism and compression of the visual pathways. Primary aldosteronism (Adr PA) is now recognised to account for 5–14% of all cases of hypertension and is associated with excess morbidity when compared with primary hypertension. Here, we report a patient who was noted to have a history suggestive of Adr PA ...