Endocrine Abstracts

Case: A 35-year-old man was referred by the haematologists. He had been previously diagnosed with dilated cardiomyopathy and later underwent a cardiac transplant. Following this, he suffered an anterior wall myocardial infarction with subsequent congestive cardiac failure. A coronary angiogram did not reveal any evidence of allograft coronary artery disease. His medications included diuretics, immunosuppressants and warfarin. There was no significant family history. Clinical e...

Duloxetine is a serotonin/norepinephrine reuptake inhibitor, prescribed frequently as a first line treatment for Diabetic neuropathy. It is also prescribed for treatment of depression, anxiety disorder and chronic musculoskeletal pain. Hyponatremia is a known adverse effect of most SSRIs including duloxetine and can potentially be life-threatening.Duloxetine induced hyponatremia, however, is relatively rare specially on low doses and is typically seen in the elderly frail pati...

Introduction: Hyperandrogenism is an uncommon finding in postmenopausal women. Possible sources of the elevated androgen levels include Cushing’s syndrome, Polycystic ovarian syndrome, benign and malignant androgen secreting ovarian tumors, ovarian hyperthecosis, adrenocortical tumours and iatrogenic hirsuitism.Case: A 65 year-old lady was referred with a raised testosterone level of 2.6 nmol/l [0–1.8 nmol/l]. She experienced weight gain and fa...

Case history: 81 year-old female was admitted to hospital with pneumonia. Past medical history included laryngeal cancer (1996), laryngectomy, iatrogenic hypoparathyroidism, hypothyroidism, and pulmonary tuberculosis (2007). She was treated with different antibiotics without improvement. She had positive aspergillus serology, but cultures were negative. She was started on voriconazole which was later changed to itraconazole 100 mg twice daily and discharged home. She was seen ...

Introduction: Premature ovarian insufficiency (POI) affects approximately 1% of females. In POI, hormone replacement manages symptoms and reduces the risk of bone mineral density (BMD) loss as oestrogen acts to enhance bone deposition in bone remodelling. Oestrogen may be given either as synthetic oestrogen (ethinylestradiol) as in most combined oral contraceptives (COCP), or as physiological oestrogen (oestradiol) as in hormone replacement therapy (HRT preparations) and a sel...

When investigating patients for possible Cushing’s, repeat testing should be considered despite initial negative results if there is a high index of suspicion. We report a case of a patient whose initial tests for Cushing’s yielded conflicting results; cyclical Cushing’s Disease was diagnosed following persistent testing. A 40 year-old lady (BMI 38.0 kg/m2) was seen in the obesity clinic with a 12-month history of weight gain. She had clinical feature...

Introduction: Thyrotoxicosis classically presents with tremor, goitre, sweating and diarrhoea. It is increasingly appreciated, however, that presentations can be complex and non-specific. Gastrointestinal symptoms in thyrotoxicosis are thought to derive from increased motility. Thyroid overactivity may be a cause for unexplained repeated vomiting and abdominal pain.Case: A case of 41-year-old man presented with a three-year history of intractable vomitin...

Introduction: Guidelines for the use of GH in GH deficient adults were issued by the UK National Institute for Clinical Excellence (NICE). To assess current practice in relation to these guidelines, a review of patients receiving GH treatment was performed. The aims were to i) assess if adults with GH deficiency met NICE criteria for GH therapy and ii) identify reasons for initiating or continuing GH treatment if NICE criteria were not met.Methods: Retro...

Introduction: Cinacalcet acts at the calcium-sensing receptors on parathyroid cells to increase the sensitivity to circulating calcium concentrations. Studies have shown that this treatment is an effective means of managing hypercalcaemia in primary hyperparathyroidism.Aims: The aim of this study was to determine the outcomes of patients who had received cinacalcet for at least 3 months for primary hyperparathyroidism.Methods: We i...

A 33 year old white European patient presented at 32 weeks gestation with a three day history of severe epigastric pain radiating to left flank with vomiting. She had pre-existing hypertension, controlled with labetalol. On admission, her BP dropped from 170/100mmHg to 90/70mmHg. Abdominal examination revealed epigastric tenderness without peritonism. There were no Cushingoid features. An abdominal ultrasound scan was normal. An MRI scan showed a bulky left adrenal gland, with...