Endocrine Abstracts

A 32 year old female presented with recurrent episodes of severe hypoglycaemia. Type 1 diabetes had been diagnosed 10 years earlier and she had undergone subtotal colectomy/ileostomy 20 months earlier for chronic diarrhoea. Histology suggestive of eosinophilic colitis. High stoma output (>4 litres per 24 hours) was causing stomal incontinence with disruption of normal lifestyle. Treatment with combinations of loperamide, codeine, omeprazole and octreotide were ineffective....

Gynaecomastia is common, occurring in 30–50% of healthy men, and its aetiology is usually benign. Clinical features inclusive of recent onset, rapid progression, and loss of libido and muscle strength, indicate the need to exclude a malignant aetiology.A 48-year-old man presented with an 18-month history of such clinical features. Investigations revealed cortisol 1136 nmol/l, 17-hydroxyprogesterone 6.6 nmol/l, androstenedione 13.3 nmol/l, DHEAS 21.8...

A 48-year-old female received radioiodine ablation therapy for thyrotoxicosis secondary to a solitary toxic nodule. The subsequent unexpected requirement for replacement thyroxine was explained by Hashimoto’s thyroiditis with an anti-thyroid peroxidase antibody level of 692.3 IU/ml. Thirty months later she presented with debilitating left facial pain and painful sensory symptoms of her left arm and leg. She was euthyroid taking thyroxine 75 μg daily with a fT4</...

A 34-year-old female presented with an 18 months history of secondary amenorrhoea, hirsutism, weight gain and low mood. Examination confirmed typical stigmata of Cushing’s syndrome with skin thinning, purpura, acne, facial plethora, central adiposity and hypertension. Investigations revealed fT4 14.7 pmol/l, fT4 4.1 pmol/l, TSH 0.71 μ/l, prolactin 377 μIU/ml, FSH 3.5 μ/l, LH 2.2 μ/l, oestradiol 140 pmol/l, testosterone 5.1 nmol/l,...

A 68-year-old female was found to have a supra sellar mass on CT scanning for investigation of long-standing tremor. She had experienced thirst, polydipsia, polyuria, nocturia and malaise for 1 year. Primary hypothyroidism had been diagnosed 5 years earlier. A left temporal visual field defect found 3 years earlier had been attributed to a structural anomaly of the optic nerve head. MR scanning confirmed the presence of a mass lesion of the infundibulum with displacement of th...