Endocrine Abstracts

A 61 year-old woman presented with a two year history of facial hirsutism and frontal balding. She did not report voice change or acne. Menarche was at age 14 with regular menses until a hysterectomy (with ovarian preservation) for menorrhagia aged 29. She had a past medical history of T2DM and gastric bypass surgery. She was not on androgenic medication. Examination revealed clinical hyperandrogenism with androgenic alopecia and hirsutism (FG score 20) but no cliteromegaly. T...

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...

Klinefelter syndrome is the most common genetic cause of primary hypogonadism in men. Upto 80% have karyotype 47 XXY. It can present with a wide range of phenotypical and biochemical abnormalities. It is also known to be associated with certain autoimmune diseases. We describe a rare case of Klinefelter syndrome with partial hypopituitarism and suggest screening with full pituitary profile plus dynamics tests at first presentation if clinical suspicion is high. A 36 year old m...

A 60-year-old woman presented to the endocrine clinic with significant hirsutism and male-pattern baldness, progressive since the menopause 5 years earlier. She was otherwise fit and well. Testing revealed an elevated serum testosterone of 14.2 nmol/L. A CT scan revealed a large malignant 19 cm mass arising from the left adnexa, a large fibroid uterus and 2 small masses in the left kidney. Other abdominal organs were normal with no visible ascites. With the presumption of mali...

Introduction: Klinefelter’s syndrome (KFS) is associated with an increased risk of certain malignancies; including leukemia, breast cancer and mediastinal germ cell tumours. Testicular tumours are uncommon. Epidermoid cysts are benign tumours of hair-growing areas. Testicular epidermoid cysts are very rare and account for 1–2% of all testicular tumours. We report a rare case of bilateral epidermoid cysts in a patient with Klinefelter’s syndrome.<p class="abs...

A 35 year old woman was referred to Endocrinology after imaging investigating unexplained pyrexia demonstrated an absent uterus. She was of Pakistani origin and was born phenotypically female with reported normal female genitalia. During late teenage years she experienced virilisation with deepening voice, increased pubic and axillary hair and clitoromegaly. She had absent breast development. Her parents were first cousins and siblings were unaffected. Investigations in Pakist...

Case: We report the case of a 22-year-old lady with pubertal arrest from a prolactinoma. She was diagnosed with a prolactinoma elsewhere at age 16 years when she presented with headaches, visual field defects and primary amenorrhea. She attained pubarche and telarche at ages 11 and 14 respectively. Pituitary MRI showed a 22 mm pituitary mass. Initial tests 6 years ago showed high prolactin, secondary hypothyroidism, low IGF-1 and gonadotropins. Cabergoline and levothyroxine we...

A 48 years old lady with BMI of 46kg/m2 was postmenopausal since age 45. Due to abdominal discomfort she had an abdominal CT, which incidentally identified bilateral adrenal adenoma (9 mm on right, 18 mm on left, with fat content). This resulted in Endocrinology referral and a history of gradually worsening hirsuitism was uncovered. Her hyperandrogenism was confirmed biochemically with markedly elevated testosterone at 6.5 nmol/l (0.0–1.8), leading to a search ...

Introduction: Testosterone replacement therapy is the standard treatment for hypogonadism. However, there are also serious side effects which clinicians should be aware of. Here we present a case of unusual side effect related to testosterone therapy.Case history: A 90 year-old gentleman attended A&E with gradually worsening confusion and dyspnoea. His breathing had deteriorated in the last week with marked decrease in exercise tolerance. Investigati...