Endocrine Abstracts

Hypopituitarism is a recognised complication of pituitary and hypothalamic pathology. It can also be a consequence, less commonly, of traumatic brain injury. It has never been described in patients following recovery from a cardiac arrest. We present a case history of hypopituitarism following successful cardiopulmonary resuscitation for a ventricular tachycardia (VT) cardiac arrest. A 51 year old patient with known prolonged QT (Romano ward) syndrome and chronic obstructive a...

Introduction: Post-surgical hypoparathyroidism (PoSH) is common after thyroidectomy. Most cases recover within 6 months, but several require long-term supplementation with calcium and activated vitamin D. When PoSH persists beyond 6 months, it is considered to be ‘long-term’ or ‘permanent’. However, few studies have demonstrated recovery beyond this time period.Aim: Aim of this study is to determine the frequency of late recovery in t...

Pituitary apoplexy arises when haemorrhage and/or infarction occurs within a pituitary tumour. In Malta, the estimated standardised incidence rate (SIR) of apoplexy is 0.15/100,000/yr. ACTH secreting pituitary adenomas have a SIR of 0.17/100,000/year.Case Report: A 46 year-old gentleman with a history of poorly controlled diabetes mellitus was referred following the diagnosis of a pituitary adenoma. He had presented with a 1.5 year history of left third ...

A 32-year-old man was referred for investigation of spastic paraparesis. There was a history of two seizures in the past. Of note was that his mother had previously been investigated for a mild spastic paraparesis, and had been diagnosed with idiopathic generalised epilepsy. MRI scan of the cervical and thoracic cord appeared normal but the MRI brain scan showed diffuse high signal intensity areas in the occipital white matter of both cerebral hemispheres. An EEG suggested idi...

The adrenal cortex is a dynamic organ that undergoes self-renewal. In the mouse it is divided into two concentric layers, the outer zona glomerulosa (ZG) and the inner zona fasciculata (ZF), that secrete aldosterone and corticosterone, respectively. Capsular and subcapsular stem/progenitor cells differentiate and migrate in a centripetal fashion to repopulate the gland until they reach the juxtamedullary region where they undergo senescence and apoptosis. Cell fate mapping stu...

Background: Addison’s disease is characterised by immune mediated destruction of the adrenal glands. This process is widely deemed to be irreversible. We present a case of confirmed Addison’s disease where adrenal function appears to have spontaneously recovered.Case report: A 37-year-old presented in 1997 with classical Addison’s disease: pigmentation, dizziness, weight loss, and nausea. There was no relevant family history. Random cortis...

Aim: Thyroid hormones play an important role in bone remodeling. The aim of the study was to evaluate the changes of bone markers and osteoprotegerin (OPG)/sRANK-L levels during follow-up in a group of patients with thyroid cancer.Material and methods: Twenty euthyroid women with the diagnosis of differentiated thyroid cancer were enrolled to the study (39.25±13.46 years, 6 postmenopausal) before thyroidectomy. Samples were collected before the oper...

Introduction: We have recently presented data demonstrating total body and regional bone mass relative to body size is reduced in obese children. Adipokines have been shown to play a role in bone metabolism. We hypothesised that 1) increased bone turnover would be associated with reduced bone mass 2) increased serum leptin would be associated with increased osteoclastogenic factors 3) reduced adiponectin woul...

Case history: A 63-year-old female was admitted to our hospital in January 2022 with neck swelling that had developed over five days with associated dysphagia to fluids. Biochemistry revealed severe hypercalcaemia with a corrected calcium of 3.82 mmol/l (2.20 - 2.60 mmol/l) and PTH of 78.7 pmol/l (1.6 - 6.9 pmol/l), and an associated AKI (creatinine of 174 umol/L from a baseline of 80). Ultrasound initially showed a left-sided 3 x 2 cm nodule suggestive of a large parathyroid ...

Introduction: Immunotherapy has advanced significantly over the past years. Immune-related adverse events (IRAEs) are various and include endocrinological complications such as Ipilimumab-induced hypophysitis (IIH). The incidence of this cytotoxic T-lymphocyte antigen 4 antibody ranges from 0 to 17%. Patients usually present with symptoms secondary to hormonal insufficiencies.Case report: A 73 year-old lady, known case of metastatic melanoma on immunothe...