Endocrine Abstracts

A 65-year-old Afro-Caribbean gentleman, with a >10-year history of hypertension, frequently recorded blood pressures of >160/80 mmHg. His serum electrolytes showed Na+ 145 mmol/l and K+ 3.2 mmol/l. MRI demonstrated 13 mm left medial-limb adrenal adenoma. His hypertension was uncontrolled on treatment with amlodipine 10 mg OD, spironolactone 50 mg OD, losartan100 mg OD and doxazosin 16 mg OD. Although his quality of life was reduced, and he dislike...

Case history: Herein, we report the case of a 79-year-old male who presented acutely to A&E with recurrent episodes of symptomatic hypoglycaemia. A random glucose at presentation was low at 1.4 mmol/l and upon correction symptoms resolved. While hospitalized, he continued having episodes of symptomatic hypoglycaemia, requiring treatment with intravenous dextrose and per os steroids. Once stable, he was discharged with advice.Investigations: ...

Section 1&2: Case history and investigations: We report the case of a 52-year-old man with recurrent immunodeficiency-related Burkitt’s lymphoma. 11 years following remission of his disease he presented with a firm lump in the parotid region. A biopsy showed histopathological evidence of a relapse. An 18F FDG PET was undertaken to determine the extent of the disease and response to R-DHAX chemotherapy. Areas of high uptake were identified in both sides of t...

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...

Case history: An 18-year old lady being investigated for anaemia, was incidentally found to have a 15 cm left adrenal mass. History taking revealed a 6-month history of weight gain, fatigue, and hirsutism. Past medical history was positive for mental illness. There was no learning disability or history of epilepsy. Physical examination was unremarkable.Investigations: Biochemical work-up for a functional adenoma revealed normal serum cortisol and circadi...

A 65 year-old male was evaluated at another hospital for frequent episodes of fainting preceded by sweating, palpitations fatigue and hunger over several years. There was no personal or family history of diabetes mellitus. Hypoglycaemia was confirmed on a supervised fast and, guided by some equivocal uptake on a dotatate scan, he underwent a distal pancreatectomy, but the symptoms persisted. He was referred to our centre. He reported relentless weight gain and a need to eat po...

Resistance to thyroid hormone (THR) is a rare genetic condition affecting the nuclear thyroid hormone receptor, and inherited in a dominant negative pattern. It is often diagnosed in patients with discordant thyroid function. Patients have a ‘pituitary resistance’ to the elevated circulating levels of thyroid hormone, resulting in the failure of TSH suppression. While this consequent TSH drive has been associated with follicular thyroid cancer, it is thought that coe...

Case history: A 51 year old gentleman presented to ED with severe right thigh pain, a 6 month history of weight loss, and 2 weeks of polyuria. He had no medical history and took no regular medications. He worked as a postman, was a non-smoker and non-drinker.Investigations: Bloods showed adjusted calcium of 5.04 mmol/l, parathyroid hormone (PTH) 1.4 pmol/l, and alkaline phosphatase 438 IU/l. Vitamin D was reported one week later as 37 nmol/l. His haemogl...

Section 1: Case history: A 19-year-old British-Asian man presented with a two-year history of gynaecomastia. He had no other symptoms of hypogonadism. He had an unremarkable past medical history, did not take any regular medications and denied the use of any illicit drugs. There was a family history of consanguinity, with his parents being first cousins. On examination, his BMI was 28 kg/m2 and he had post-pubertal-sized testes (20 ml) with normal secondary sexual c...

Section 1: Case history: A 30 year-old female patient with a background of symptomatic primary hyperparathyroidism diagnosed in 2008 and a history of two failed neck surgeries, was reviewed in clinic complaining of persistent symptoms of hypercalcaemia. Previous pre-operative neck imaging had failed to localise a parathyroid adenoma and the patient had undergone two neck explorations by an experienced ENT surgeon; one which removed thymic tissue and the other which removed a m...