Endocrine Abstracts

44 years old gentleman referred to endocrinology clinic complaining of reduced libido. Initial blood test showed borderline low testosterone levels measuring 8.4 nmol/l (10–37) on 2016. SHBG 28. He has a past medical history of type 2 diabetes diagnosed March 2015, fibromyalgia, bilateral carpal tunnel syndrome, spinal osteoarthritis and asthma. medication includes Amitriptyline 30 OD, Buprenorphine 15 μg patches weekly and inhalers together with metformin and sitagl...

Introduction: Hypogonadism is linked to anaemia, sarcopenia and osteoporosis in men. Whereas secondary hypogonadism (SH) is biochemically indistinguishable from nongonadal illness, primary hypogonadism (PH) can be easily diagnosable by the identification of raised gonadotropins.Case Presentation: A 66-years old male with a background history of type 2 diabetes mellitus, arthritis, and hypertension was referred to the haematology services to investigate h...

This is a 46 year old man who was referred by GP for erectile dysfunction. He is a married with two daughters. His complaint started 1 year back with lethargy and tiredness. He is fit and well. He does not take any regular medication. He is shaving regularly. On examination, wt 80 kg. All the secondary sexual characteristics were present. No Galactorrohoea. Testes size was normal. His total testosterone level was low. Anterior pituitary hormone profile showed very low LH and F...

Background: Functional hypothalamic amenorrhoea (FHA) is a common cause of secondary amenorrhoea and is related to a combination of weight-loss, exercise and psychological stressors. These factors lead to suppression of pulsatile GnRH secretion. Diminished LH and FSH concentrations result in a hypoestrogenic state. We present an archetypal case of FHA that clearly demonstrates the ‘hypothalamic set-point’ for the body composition of a young woman below which...

Introduction: We describe a case of a 29 year old man who was referred to endocrinology services with a 4 month history of erectile dysfunction, decreased libido and low testosterone. He denied symptoms suggestive of pituitary pathology. And he had no previous testicular infections or trauma. His past medical history included asthma, which was well controlled with b-agonist inhaler as required. He had normal development. He was a non smoker, abstinent from alcohol and a keen c...

Case: A 20 year old female was referred for further evaluation of ovarian function. She has a history of beta thalassemia and bone marrow transplant in 2009 at age 11. Her menarche started in 2008 and she continued having regular periods until shortly after her bone marrow transplant. She was subsequently started on Loestrin oral contraceptive pill. Examination showed a height of 164 cm and weight of 57 kg. She had well developed secondary sexual characteristics. Her OCPs was ...

Case: A 34 year old was reviewed in reproductive clinic for gonadotropins therapy prior to micro-TESE. He was diagnosed with Klinefelter syndrome in his 20s in another hospital. Testosterone replacement was initiated with Nebido injection. However, he developed polycythemia, DVT and PE in 2013 and therefore the testosterone replacement was stopped. He had thrombophilia screen that showed heterozygous prothrombin gene mutation. Thereafter, he received anticoagulation for few mo...

A 38-year-old gentleman was referred to the endocrine clinic after a male fertility test done as part of investigation for infertility showed the following:Volume 4.4 mlTotal sperm number =6.16 Mill/ejacSperm concentration 1.4 Mill/mlProgressive motility 10%Nonprogressive motility 1%Impotence 89%55% sperm vitality<...

A 33-year-old male with a background of idiopathic hypogonadotrophic hypogonadism was referred to the endocrine clinic to discuss fertility. He was originally diagnosed overseas when presented with delayed puberty in late teens. He had a normal pituitary MRI and since then he had been on testosterone replacement; other pituitary function was normal. He was not anosmic however no other information was available from diagnosis. When he attended the clinic the patient and his wif...

A 45 year old man was referred to endocrinology with increasing weakness, lethargy, loss of libido and erectile dysfunction. Initial investigations showed hypogonadotrophic hypogonadism with testosterone 0.8 nmol/l (8.2–32.2), FSH <1 U/l, LH<1 U/l, SHBG 93 nmol/l and secondary hypothyroidism with TSH 1.65 mU/l, FT3 2.1 pmol/l FT4 9 pmol/l, prolactin 180 mU/l, IGF-1 12.5 nmol/l. Short synACTHen test showed normal adrenal response (692 to 1014 nmol/l) with a higher ...