Endocrine Abstracts

An 18-year-old male came to medical attention for complaints of non-healing ulcers on right medial aspect of lower leg and left medial malleolus of two years duration. His mother had noticed that he had put on weight particularly around breasts, hips, and thighs for last three years.On examination his height was 196 cm and weight 106 kg. The upper segment to lower segment ratio was 0.82 (mean 0.92 in white adults, 0.85 in black adults), and arm span 207 ...

A 24-year old male was referred to endocrinology outpatient with absence of hair on scalp, eyebrows, eyelids, and body since birth, short stature, bone pains, proximal muscle weakness, and recurrent fractures of long bones. He was a product of second degree consanguineous marriage. He was eldest of two siblings. His younger brother aged 16-years was suffering from similar complaints.Clinical examination revealed alopecia universalis, short stature, hypot...

The foetus of a mother with previous or current Graves disease is at risk of developing thyrotoxicosis. The mother can act as a bioassay to diagnose foetal thyrotoxicosis. We describe the difficulties in managing foetal thyrotoxicosis in a mother who could not act as a bioassay because of previous Graves disease treated by total thyroidectomy.A 35year old woman fell pregnant 3 months after a total thyroidectomy for relapsed Graves disease and concomitant...

A 41 year old male presented with erectile dysfunction associated with clinical hypogonadism (testosterone 0.8 nanomoles/litre). Hypopituitarism was confirmed on endocrine testing: Free T3 2.7 picomoles/litre, TSH 1.7 milliunits/litres, LH 0.6 units/litre, FSH 2.3 units/litre, PRL 34 units/litre, GH <0.5 milliunits/litre, IGF-1 10.5 nanomoles/litre, flat response of LH and FSH to Gn-RH, GH <0.5 milliunits/litre throughout ITT. (Cortisol rose from 197 to 523 nanomoles/lit...

We report a 36 year old woman of African origin with a background of HIV and previous AIDS defining pulmonary tuberculosis. The patient has been well on highly active anti-retroviral therapy (HAART) since May 2000. She presented in March 2001 with a four weeks history of fatigue, weight loss, palpitations, polyuria and weakness. Her mother had type 2 diabetes. There is no family history of thyroid disease. Examination showed a thyrotoxic state, a smooth diffuse goitre and prox...

We report the case of a 74 year old woman, admitted as an emergency with suspected pelvic malignancy in whom the clinical features and the positive tumour markers were actually due to hypothyroidism. The presenting features included cachexia, anorexia and severe ascites. Vital signs were normal. Examination revealed bilateral pleural effusions but no abdominal masses were palpable. Rectal examination was unremarkable. Investigations showed an extremely elevated CA 125 level of...

Polycystic ovarian syndrome (PCOS) is the commonest cause of hyperandrogenism in women. Severe hyperandrogenism or virilisation, however, suggest the need to consider rarer causes e.g. Cushing's, congenital adrenal hyperplasia and androgen-secreting tumours. Here we present a case of PCOS where the remarkable response of severe hyperandrogenism with polycythaemia to metformin excluded these rarer causes without the need for complex or invasive investigation.<p class="abste...

A 21 year-old woman of Indian descent, but UK born and bread presented with a two-year history of intermittent headaches, hot flushes, polydipsia, nocturia and amenorrhoea. One year previously she had been diagnosed with primary hypothyroidism with a TSH of 7.3 and FT4 of 6.5. She was treated with thyroxine but remained amenorrhoeic.Subsequent evaluation revealed TSH, LH, and FSH deficiency with evidence of cranial diabetes insipidus. An MRI scan of the ...

Ganglioneuroblastoma is a rare neoplasm of adults, containing both primitive neuroblastomatous and mature ganglioneuromatous elements of sympathetic cell origin. We describe an adult patient with a ganglioneuroblastoma exclusively secreting dopamine.A 41 year old lady represented 6 days post laparoscopic excision of endometriosis with a 2 day history of right sided abdominal pain. Only on direct questioning did she admit to a vague 2 month history of occ...

IntroductionPrimary hyperparathyroidism (PHP) due to adenoma or hyperplasia is common and is being increasingly diagnosed. Overall 80% are due to single adenoma, 15% to multiglandular hyperplasia, 3% to multiple adenomata (usually 2) and 2% to carcinoma. In 20-30% the glands will be ectopically placed, usually within the neck, though can be anywhere from the skull base to the diaphragm.Surgery is the treatment and a longterm debate...

We report an 18-year-old boy referred to our outpatient clinic at 8 years and 11 months of age with a history of early-onset childhood hiperphagia, infantile central hipotonia and lethargy, mild mental retardation and emotional instability. His height was 125 cm, height SDS = -1 (target height = 169,5 cm, SDS = -0,78) and he weighted 40 Kg (BMI = 25,6;WFH =164%). He had small hands and feet, fat face with prominent forehead, bitemporal narrowing, triangular upper lip, microgna...

A previously fit 36 year old lady presented with 3 days of pleuritic chest pain and SOB. A CxR showed consolidation at the left heart border. Following antibiotics she made a good recovery. On examination an incidental right thyroid nodule was identified. She was clinically euthyroid. FT4,FT3 were normal and TSH suppressed. The CxR a month later did not change. A CT scan revealed a 5x4cm mass in the left lower lobe, abutting the descending aorta and left atrium. Bronchoscopy r...

Aspergillus infection of the paranasal sinuses is an unusual phenomenon but is the commonest fungal infection of these structures. A 67 year-old man was admitted with six months' lethargy, vomiting, and weight loss. Past history included sinusitis. On examination he was well but dehydrated. BP 100/60. No other abnormal findings. Routine blood results were normal.A provisional diagnosis of upper GI malignancy was made but gastroscopy was normal. The thyro...

Introduction: Klinefelter`s syndrome is a chromosomal abnormality characterised by presence of one or more extra X chromosome(s). The commonest karyotype is 47 XXY. We report a case of craniopharyngioma in a patient with Klinefelter`s syndrome.Case report: A 72-year-old single male presented with three-month history of decreased left eye visual acuity with associated frontal headache and lethargy. His past medical history included osteoporosis and Klinef...