Endocrine Abstracts

A 55 year old man was seen in an endocrinology clinic for possible diagnosis of Cushing’s syndrome. He described a 6 months history of feeling lethargic and increased facial puffiness and abdominal fat. There Cushingoid signs on examination, namely; moon facies, thin skin and bruises with increased abdominal fat distribution. He was admitted to hospital following symptomatic hyperglycaemia and hypokalaemia (lowest reading 2.7 mmol/l). Initial laboratory results showed rai...

Pheochromocytoma is a rare disorder of chromafin cells and can be incidentally found in 20% of adrenal masses. It can be malignant in upto 10% of the cases. Metastatic disease poses a great challenge and no definitive cure is yet established to treat these tumors.We report a case of 54-year-old male patient with past medical history of anxiety who presented with acute left sided abdominal pain to the urology department at Norfolk and Norwich University H...

This case highlights the importance of investigating for secondary causes of hypertension especially in young people. The patient was referred to exclude Conn’s disease, this case outlines the limitations one may face when interpreting the results of subsequent tests. Miss K was 24 years old when she was initially admitted under the Nephrologists with headache, palpitations and significant hypertension with systolic blood pressure (BP) of 275.Her ec...

54 year old lady presented to the endocrine clinic. She was diagnosed with breast cancer and right ovarian tumour at the same time in August 2015. She had right lumpectomy of breast and Salpingo-Oophorectomy in November 2015. She was not feeling very well for the last few weeks. She complained of extreme lethargy and tiredness. She had blood test done on 15th November 2016 that showed prolactin level at 2849 nmmol/l with negative macroprolactin. Hence, she was referred to the ...

Case: A 29-year-old gentleman with HIV was self-administering anabolic steroids. The abrupt discontinuation of the exogenous anabolic steroids resulted in fatigue and abdominal pain. A short synacthen test confirmed adrenal insufficiency.His past medical history comprised of HIV which was stable on anti-retroviral therapy. He was commenced on Hydrocortisone 10 mg in twice daily.Over 1 year he developed clinical Cushings. Discontinu...

Primary Aldosteronism (PA) is caused by autonomous aldosterone production from the adrenal cortex (due to hyperplasia, adenoma or rarely carcinoma) and diagnosis is confirmed by elevated plasma aldosterone level with suppressed renin activity and localized further by CT scan of the adrenal glands and selective adrenal venous sampling (AVS) if required. On the other hand, Addison disease (also known as primary adrenal insufficiency) which represents the other face of the coin i...

A 54-year-old female presented to her GP with a 9-year history of poorly controlled hypertension (requiring five drugs) and type 2 diabetes mellitus, associated with central weight gain, low mood and poor wound healing. On examination she had clinical evidence of glucocorticoid excess. Cushing’s syndrome was confirmed on low dose dexamethasone suppression testing (2+0 cortisol 857 nmol/l, 2+48 cortisol 346 nmol/l). Cushing’s day curve demonstrated loss of circadian r...