Endocrine Abstracts

Addison's disease was first described by Thomas Addison in 1855 and at that time was mostly caused by destruction of the adrenal glands by tuberculosis. In current endocrine practice the most common cause of Addison's is an autoimmune attack on the adrenals, and TB is a rare cause. Other adrenal diseases and infiltrations can also rarely cause the condition. Prevalence is approximately 40–60 cases per million population with incidence of 3–4 new cases/million per yea...

A 66-year-old man was referred in May 2004 with history of rapid onset of diabetes, severe back pain with vertebral collapse and hypokalaemia (K+2.9 mmol/l). GP suspected Cushing’s syndrome. Random cortisol was 905 nmol/l and 24 h urinary free cortisol 1741 nmol/24 h.He was admitted for investigations which were highly suggestive of ectopic ACTH secretion with cortisol levels failing to suppress after low- and high-dose dexamethasone and ACTH levels...

A 67-year-old lady with no significant past medical history presented with a left-sided neck swelling. An FNA under ultrasound scan guidance revealed malignant cells of indeterminate origin. Left neck exploration revealed an enlarged left lobe of thyroid and a retrosternal mass extending into the aortic arch. A left thyroid lobectomy and removal of retrosternal mass was performed and the histology showed a thyroid colloid goitre and low grade paraganglioma respectively. She wa...

A 32-year-old man was referred for investigation of spastic paraparesis. There was a history of two seizures in the past. Of note was that his mother had previously been investigated for a mild spastic paraparesis, and had been diagnosed with idiopathic generalised epilepsy. MRI scan of the cervical and thoracic cord appeared normal but the MRI brain scan showed diffuse high signal intensity areas in the occipital white matter of both cerebral hemispheres. An EEG suggested idi...

We audited the management of adrenal incidentaloma (AI) in our hospital.29 patients (12 male) were referred with AI, mean age 68y (48–87 years). Mode of detection: 7 ultrasound (2 no mass on subsequent CT/MRI), 20 CT, 1 MRI and 1 lumbar XR. Site of tumour: 18 right, 7 left, 1 bilateral, 1 N/A. Size: <4 cm in 17, 4–6 cm in 4, >6 cm in 2, “large” in 1, not stated in 4. History: 8 had clinical features of possible hormone excess....

Objective: Biochemical assessment of male hypogonadism relies on estimation of freely available testosterone. Gold standard measurement is by equilibrium dialysis but this is not practical in clinical use. We compared two calculation methods; bioavailable (non-SHBG bound) testosterone (Morris et al.), and free (non-SHBG non-albumin bound) testosterone (Vermeulen et al.) for their diagnostic performance.Design: Free testosterone and bioa...

Case History: An 84-year-old women presented to a psychiatric unit with a 5-month history of fluctuating confusion, paranoid behaviour, anxiety, reduced cognition and unsteadiness. There was no history of galactorrhoea, headache or visual field disturbance. Past medical history included hypertension, chronic kidney disease, congestive heart failure, premature menopause and hyperlipidaemia. She had been taking bendroflumethiazide, furosemide, mirtazepine and sulpiride. A CT hea...

Case: A 73-year-old lady presented with hyponatraemia six days post-transphenoidal surgery for a non functioning pituitary macro-adenoma. Peri-operatively she developed diabetes insipidus requiring short term desmopressin whilst on the neurosurgical ward. At post-operative presentation she complained of weakness, confusion and nausea; sodium 125 mmol/l, serum osmolality 268 mOsmol/kg, urine osmolality 474 mOsmol/kg. Over the next few days she became symptomatically worse and h...

Introduction: Dopamine Agonists are important in the management of endocrine disorders such as acromegaly and hyperprolactinaemia. Recent studies have shown that Cabergoline used in high doses to treat Parkinson’s disease is associated with cardiac valve fibrosis.Methods: We identified patients on long term high-dose cabergoline for the management of acromegaly. The following data was analysed: demographic data, duration of treatment, cumulative dos...

Introduction: Riedel’s thyroiditis is a rare disorder of unknown aetiology and may be seen isolated or as a part of multifocal fibrosclerosis. Multifocal fibrosclerosis involves two or more fibrotic disorders including Riedel’s thyroiditis, retroperitoneal fibrosis, sclerosing mediastinitis, retro-orbital pseudotumour and sclerosing cholangitis. We report a case of recurrent Riedel’s thyroiditis as part of multifocal fibrosclerosis presenting with a woody neck s...