Endocrine Abstracts

A 44 year old lady presented with weight loss to the gastroenterologists and a CT abdomen done picked up a mass below the pancreas. She underwent a percutaneous biopsy of this mass and the histology revealed a paraganglioma. She was referred to the endocrinology team. Subsequent questioning revealed coexistent symptoms of cataecholamine excess and plasma metanephrines of 4825 pmol/l and plasma normetanephrines of 166 pmol/L gave biochemical confirmation. MIBG scan showed a dir...

Kallmann syndrome is a treatable form of male infertility caused by a congenital defect in the secretion or action of gonadotropin releasing hormone (GnRH). It can permanently remit in around 10% of male cases. We report a patient with atypical Kallman’s syndrome who requires intermittent testosterone replacement to sustain activity of his gonadotrophic axis A 55 year old male presented with erectile dysfunction and decreased libido. He reported normal puberty, with no hi...

Background: The treatment of choice for symptomatic primary hyperparathyroidism (PHPT) is surgery, however in many cases patient choice or medical comorbidities preclude this treatment modality.Aim: This audit examines the use of cinacalcet in management of primary hyperparathyroidism in a district general hospital to determine if it is in accordance with the National institute for health and care excellence (NICE) guidance (May 2019).<p class="abste...

Background: Functional hypogonadotrophic hypogonadism (FHH) occurs in the context of any chronic disease including obese patients with type 2 diabetes (T2DM) and/or metabolic syndrome. FHH is reversible with resolution of the underlying disease process. Reported benefits of bariatric surgery include improvements in lipid profile, blood pressure and resolution of T2DM. Here we report reversal of FHH and T2DM with bariatric surgery-associated weight loss.C...

Background: Hypogonadotropic hypogonadism in apubertal males is commonly due to constitutional delay; permanent gonadotropin deficiency becomes more likely with older age at presentation, cryptorchidism and non-reproductive defect, e.g. anosmia. All forms of testosterone induce pubertal development, though short-acting IM preparations are associated with extraphysiological excursions of serum testosterone and are increasingly unavailable. Long-acting testosterone undecanoate I...

Background: Routine measurements of serum calcitonin levels are considered an integral part of the diagnostic evaluation of medullary thyroid cancer (MTC). We report a rare case of calcitonin and carcinoembryonic antigen (CEA) negative MTC.Case presentation: A 63-year-old retired plasterer attending a well mans clinic was referred to the endocrinology service with elevated calcium (2.75 mmol/dl). Systemic examination was unremarkable and there was no end...

Introduction: Diabetes insipidus can complicate up to 1 in 30 000 pregnancies and has a variety of causes, some that predate the pregnancy and others that begin during gestation. In addition, women can experience diabetes insipidus de novo in pregnancy through the actions of placental vasopressinase, which causes accelerated degradation of vasopressin. This form of diabetes insipidus may be associated with increased complications of pregnancy, including pre-eclampsia. M...

Medullary thyroid cancers (MTC) account for about 5% of thyroid cancers. The biochemical hallmark of MTC is the secretion of calcitonin (CT). CT levels are both a key feature of pre-operative diagnosis and post-operative follow up. CT screening in a cohort of over 10 000 patients with thyroid nodular disease has demonstrated that a positive CT test has a higher diagnostic sensitivity and specificity for MTC than fine needle aspiration (FNA). They may also secrete carcinoembryo...

A 33-year-old lady presented to the surgeons with history of abdominal pain. CT scan abdomen done revealed massive adrenal enlargements reported as adrenal myelolipomas (left gland measuring 8.0×10.9×11.8 cm and multifocal lesions on the right with the larger one measuring 5.2×4.3×3.6 cm). She was referred to the endocrinology team where further history was elicited. She had been diagnosed as a child to have congenital adrenal hyperplasia (CAH) but was lost...

Background: Although hypocalcemia is common post thyroidectomy, no national guidelines pertain to its management.Long-term treatment with calcium and vitamin D replacement predispose patients to nephrocalcinosis and should be avoided in the absence of a clear indication.Aim: To identify the incidence and management of post-operative hypocalcemia following thyroidectomy in a UK teaching hospital with view to formulating management g...