Endocrine Abstracts

A 29 year old female presented with a two year history of recurrent numbness and tingling in her hands. Trousseau’s sign was positive. Investigations confirmed hypocalcaemia with serum calcium 1.64 nmol/L (2.10–2.60), phosphate 1.23 nmol/L (0.80–1.55), alkaline phosphatase 82 U/L (35–120). Parathyroid hormone was inappropriately normal at 36 pg/ml (10–65), Vitamin D 78 nmol/L (50–75). Her mother reported a history of hypocalcaemia when she was two...

Background: The use of intra-articular (IA) glucocorticoids for reducing pain and inflammation in patients with osteoarthritis, rheumatoid arthritis, and other inflammatory arthropathies is widespread among primary care physicians, specialists and non-specialists in the United States. Injectable glucocorticoids have anti-inflammatory and analgesic properties which can be effective in improving clinical parameters such as pain, range of motion, and quality of life. After inject...

Background: Ectopic pituitary adenomas are defined by the presence of adenomatous pituitary tissue outside the sella and distinctly separate from the pituitary gland. Ectopic ACTH-secreting pituitary adenomas (EAPAs) are a rare cause of Cushing’s syndrome. Detecting these radiologically can prove difficult, in part, due to their typically small size and unpredictable anatomical location.Aim: We reviewed the current literature on all previously repor...

Clinical presentation: We report a 46 year old female who presented with a 1 year history of bruising, thin skin and weight gain. In addition; she reported flushing of her chest, heat intolerance, palpitations and abdominal pain. On clinical examination she appeared cushingoid, blood pressure was elevated at 160/98 mm/Hg.Investigations: Biochemical investigations indicated ACTH-dependent Cushing syndrome: 24 h UFC 300 μg (0–50), ACTH 119 pg/ml ...

An 18 year old male presented with dyspnoea, haemoptysis, weight loss and a large right testicular swelling. On examination he appeared cachectic, diaphoretic and tachycardic. A large firm non-fluctuant right-sided scrotal swelling was present. There were no signs of goitre or dysthyroid eye disease. Thyroid function tests revealed biochemical hyperthyroidism: [fT4 38.6 pmol/L (NR: 9.4–18.6), TSH <0.01 mu/L (NR: 0.3–4.4)]. CT chest demonstrated multiple large pul...

Intranasal presentations of pituitary tumours are rare. Management can be difficult and delayed due to their location and extension. Macroprolactinomas are uncommon and can often pursue an aggressive clinical course, including invasion into the nasopharynx.We describe three cases of prolactinomas that initially presented to the ENT Department as nasal polyps. Table 1 highlights their clinical features and response to treatment. Recurrence of nasal polyps...

A 46-year-old male presented in 1981 with a 2 year history of profuse watery diarrhoea, three stone weight loss and fatigue. On examination he appeared gaunt with diffuse muscle weakness. Investigations revealed hypokalaemia (2.5 mmol/l; NR 3.5–4.5), achlorhydria and a raised vasoactive intestinal polypeptide (VIP) (1500ng/L; NR 0–100). Abdominal CT showed a 5 cm pancreatic mass but with no focal liver pathology. A distal pancreatectomy was performed. Histology confi...

Background: Transsphenoidal tumour resection (TSS) is the first-line treatment for Cushing’s disease (CD). With an experienced neurosurgeon, immediate remission rates >80% are expected for patients with microadenomas (<10 mm).Aim: To report initial and long-term remission rates in a specialist centre, and to ascertain factors associated with disease recurrence after TSS.Methods: Patients with CD (n=101, 28M, 7...

Background: Successful pituitary surgery in patients with Cushing disease (CD) can result in long term remission and sustained weight loss. We examined rates of body weight changes in the post-operative period (within 6 months) in patients with active CD who underwent transsphenoidal surgery (TSS) and the relationship of weight loss to remission status.Methods: Clinical data was obtained from a CD database in addition to an online patient medical record ...

Background: Cushing’s disease is a condition rarely encountered during pregnancy. It is known that hypercortisolism is associated with increased maternal and foetal morbidity and mortality.Aims and methods: A comprehensive search of the literature was performed for cases of Cushing’s disease in pregnancy including our own case. Analysis was performed of all pregnant patients with Cushing’s disease who were treated with surgery compared to ...