Endocrine Abstracts

Background: Endoscopic endonasal transsphenoidal hypophysectomy is an alternative to microscopic transsphenoidal hypophysectomy. The technique may provide a safer, quicker and more effective treatment.Objectives: To assess preliminary results of this technique when introduced at a single centre with a single surgeon.Methods: A retrospective analysis of 62 patients who underwent transsphenoidal surgery, 33 microscopic and 29 endosco...

We describe an 80 year-old man with Graves’ thyrotoxicosis and thyroid orbitoapthy accompanied by ocular myasthenia gravis.He presented in 2004 with chemosis, exophthalmos, diplopia, ptosis, and restricted movements. He also gave history of weight loss (six kilograms). FT4 29, FT3 7.7 and TSH 0.04. MRI Orbits revealed swelling of the extra-ocular muscles.Ocular movement was markedly restricted but a curious feature of the pres...

Purpose: Thyrotoxic patients have an increased bone turnover and decreased Bone Mineral Density (BMD) at diagnosis. During antithyroid drug treatment (ATD) the patients improved their BMD but earlier studies have not been able to determine if BMD normalize or how long it will take.Methods: We have prospectively examined 32 females (approved by Danish Ethical Committee) with newly diagnosed Graves’ disease (antilog10, mean age (CI 95%)): 39 years (34...

Introduction: In total of 5α-reductase 2 is vital in sexual development of male foetus; its deficiency causes impaired virilisation due to defective conversion of testosterone to dihydrotestosterone and is an important cause of Disorders of Sexual Development (DSD). We report 3 cases of severe primary acquired auto-immune hypothyroidism, which show a similar picture of 5α-reductase deficiency (5ARD) on urine steroid profile (USP) and reversible following adequate thy...

Section 1: Case history: At the age of 18 our patient presented with renal stones and was diagnosed with Primary Hyperparathyroidism (PHPT). At 20 she underwent a right sided nephrectomy for a calculus associated non-functioning kidney. Over the years she has had numerous renal calculi, ureteric obstructions with stents, requiring urology input. Of note she had osteoporosis, hypertension, pancreatitis, gastritis, intracranial hypertension (with shunt in situ) and resistant Vit...

Case history: We report the case of a previously healthy 69-year-old female who was referred to our centre after she presented with rapidly progressive weight-gain, hyperglycaemia, hypokalaemia and hypertension. She had no symptoms suggestive of carcinoid syndrome. On assessment, she had pathognomonic features of Cushing’s syndrome: central weight gain (peripheral wasting) proximal myopathy, leg oedema, skin thinning, bruising and facial puffiness; this appearance being m...

Background: Adrenal incidentalomas (AI) are common, with approximately 40% of these demonstrating evidence of mild autonomous cortisol secretion (MACS). MACS has been associated with increased morbidity and mortality, and some patients with MACS may benefit from medical therapy or adrenalectomy, so all require further evaluation. Given the large numbers of patients involved, this has potentially significant resource implications for outpatient endocrinology se...

Introduction: In many lower-middle income countries (LMICs), poverty, insufficient infrastructure and lack of universal health coverage affect type 1 diabetes (T1D) outcomes. Limited insulin and unavailability of blood glucose monitoring supplies contribute to poor glycaemic control and T1D complications that adversely affect mortality and morbidity. Laos is a LMIC in Southeast Asia (SEA) with a population of 7.3 million. Its GDP per capita is USD 2,534 of which only 2.5% repr...

Introduction: Duplications of the SOX3 gene at Xq27.1 are known to be associated with a spectrum of forebrain midline defects, isolated or multiple pituitary hormone deficiencies, spina bifida and sometimes learning difficulties. We report three cases of SOX3 duplication with hypopituitarism and differing presentations.Case reports: 1) A male infant presented in neonatal period with poor feeding, prolonged jaundice, central hypothyroidism and inadequate ...

Adrenocortical carcinoma (ACC) is a rare malignancy with an incidence of 0.7–2.0 cases/million habitants/year, often with a dismal prognosis. Patients present with abdominal symptoms or symptoms of hormone excess. However, 15% are diagnosed incidentally. (1) A 59y male was referred with progressive lethargy, weight loss, dyspepsia and abdominal distension over the past 2 years. He was dismissive of ‘the elephant in the room’ and in denial. He was pushed to seek ...