Endocrine Abstracts

A 67 year-old man, with metastatic prostate cancer diagnosed in July 2015, presented with a two-week history of lethargy, intermittent confusion, facial flushing, and increased thirst. Other medical history included well-controlled hypertension on irbesartan monotherapy, and paroxysmal atrial fibrillation. On examination, he was flushed and lethargic, but had no other features of Cushing’s Syndrome. His pulse was 66 bpm and BP 179/78. There was no evidence of hypovolaemia...

A 59 year old man was referred to our endocrine service for persistently elevated prolactin levels. He did not report any headache, visual disturbance or galactorrhoea. He was diagnosed with schizophrenia in 1994 and was tried on different antiphychotic drugs until established on a combination of Amisulpride and Clozapine 11 years later. For the past years, his prolactin levels had been elevated ranging from 1477 to 1972 milliunit/L [60–300]. Further history revealed that...

A 46-year-old lady presented with a short history of thirst and polyuria. She had a past history of hypertension. Diabetes mellitus was ruled out as she had normal blood glucose levels. She was found to be normocalcaemic but hypokalaemic. In view of the latter finding and her hypertension, her plasma renin activity and aldosterone was measured, and found to be 45 pmol/ml/hr and 410 pmol/l respectively (aldosterone:PRA ratio of 9.1). The diagnosis of secondary hyperaldosteronis...

A 25 year old man, with no significant past medical history and on no medication, presented to Accident and Emergency with collapse. He was anuric, hypotensive, with a sodium of 107 and a potassium of 8.8. Electrocardiographic changes showed widening of the QRS complex and tall tented T waves. He was in prerenal renal failure with a creatinine of 377 and urea of 36.9.This presentation came after a week of feeling non-specifically unwell, progressive fati...

BackgroundTSHomas are a rare cause of hyperthyroidism, and account for 0.5 to 3% of pituitary tumours. Incidence=0.15 per million per year. Prevalence=1 per million. Our limited experience of this condition can result in diagnostic and treatment challenges. Here we describe a case treated surgically lead to successful outcomesCase35 years old female referred to our service with secondary amenorrhea for the la...

Case history: We present a 76-year-old woman with cyclical ACTH-dependent Cushing’s syndrome since 2002. She has two-yearly relapses with proximal myopathy, candidiasis, facial swelling and hypokalaemia that have been biochemically confirmed with Overnight and Low Dose Dexamethasone Suppression tests. Although her initial cycles were brief and uncomplicated, her most recent episodes led to prolonged hospital admissions. During her last admission, she became septic complic...

Background: Determining post-operative remission in Cushing’s disease is challenging. There is no consensus for the post-operative serum cortisol value which reliably predicts remission of Cushing’s disease following trans-sphenoidal surgery. Traditionally, an early post-operative serum cortisol of below 50 nmol/L has been used to predict remission, but achieving this is often at the expense of hypopituitarism.<p class="abst...

Background: Determining post-operative remission in Cushing’s disease is challenging. There is no consensus for the post-operative serum cortisol value which reliably predicts remission of Cushing’s disease following trans-sphenoidal surgery. Traditionally, an early post-operative serum cortisol of below 50 nmol/L has been used to predict remission, but achieving this is often at the expense of hypopituitarism.<p class="abst...

Introduction: Acromegaly is commonly associated with numerous cardiovascular manifestations such as left ventricular hypertrophy, hypertension and ischemic heart disease. However, initial presentation with dilated cardiomyopathy is relatively rare. Dilated cardiomyopathy in patients with acromegaly usually result from an extended and excessive exposure of the myocardium to growth hormone.Case presentation: 51-year-old female with background medical histo...

A 57-year-old woman was referred in 2012 following an incidental finding of a pituitary macroadenoma. It measured 17×9 mm and was confined to the sella. There was no clinical or biochemical evidence of pituitary dysfunction. In 2017, she was found to have proximal myopathy, plethoric facies and purple abdominal striae. She was also on medication for hypertension and type 2 diabetes. There was no history of sleep apnoea, fractures or use of exogenous steroids. An MRI showe...