Endocrine Abstracts

26year old Human rights activist being evaluated for left hip and thigh pain over the preceding 7 months, was referred to our services in November 2015 with headache, secondary amenorrhoea and raised prolactin levels. The headache which was mainly frontal started a few months ago and coincided with the amenorrhoea. She did not report visual disturbances or lactation. She also described the feeling of increased thirst and increased urinary frequency over this period. Apart from...

A 33-year-old woman who was 38-weeks pregnant was referred to our Endocrine team for bilateral temporal hemianopia. Her past medical history includes juvenile myoclonic epilepsy, for which she takes lamotrigine 275mg BD. She was reviewed by the Endocrinologist in 2018 for polyuria and nocturia which were attributed to the introduction of antiepileptics (normal pituitary biochemistry and MR pituitary). Her symptoms subsequently improved. Current symptoms started with acute retr...

A 32-year-old man was urgently referred to the endocrinology and neurosurgical teams by the neuro-ophthalmologist. He gave a 3 week history of sudden onset of left-sided visual impairment, with further visual deterioration a week previously. Urgent review in the eye clinic had revealed that the visual acuity in his left eye was reduced to finger counting only, with a pale left optic disc and a relative afferent pupillary defect on examination. Visual field testing demonstrated...

A 54 year old gentleman presented to the eye services with reduced vision on the right attributed to a cataract. Following cataract surgery there was no improvement and his vision declined further with reducing vision also on the left. He was reviewed in Neuro-ophthalmology clinic 29/10/21 and clinical suspicion of a pituitary lesion based on binasal retinal ganglion cell layer loss and bilateral optic atrophy prompted urgent imaging. His right eye visual acuity was to hand mo...

Background: Prolactinomas are the most common functioning pituitary tumours, accounting for 40% of all pituitary adenomas. Prolactinomas may enlarge in pregnancy, the management of which may prove challenging. Case Presentation: A 23 year old lady was referred to the endocrine clinic with secondary amenorrhoea and bifrontal headaches in 2012. Biochemical tests on referral revealed: FT4- 5.8 pmol/l, TSH-1.1 mU/l, Prolactin-4432 mIU/l, LH- 4.8 IU/l, FSH- 4...

Case history: 66 year old male referred with a thyrotoxic biochemistry. History was in favour of a subacute thyroiditis with a painful neck and short-term elevation of fT3 and fT4 which have improved to lower limits of normal without any treatment at the time of first clinic visit. He was monitored for thyroiditis and the biochemistry gradually changed and patient started to complain of tiredness. Investigations and treatment: Morning Pituitary profile i...

Background: Tuberculosis (TB) is an important cause of mortality and morbidity globally. Only a small proportion cases of systemic TB present with lesions spreading to meninges, sella, or ventricles. Cases of intra-sellar pituitary adenoma secondary to TB have been rarely identified, often with uncertainty on medical management as opposed to more aggressive surgical therapy. We report an interesting case of pituitary adenoma presenting with pan-hypopituitarism and posterior pi...

33-year-old female presented at 35 weeks of pregnancy with black spots in the peripheral vision and headaches to Ophthalmology department. No other relevant clinical symptoms of note and no past medical history. On examination she had bitemporal hemianopia confirmed on perimetry hence was referred to Endocrine department. The MRI showed pituitary macroadenoma (1.8 cm x 2 cm x 1.2 cm), with extension into suprasellar and parasellar regions and displacement of the optic chiasm. ...

A 41 year-old male was referred urgently from secondary care with high suspicion of Cushing’s syndrome. His past medical history included psychosis and bipolar disorder, previous low impact foot fractures, rib fractures on coughing and spinal wedge fractures on X-ray, all within the last 5 years. He was taking quetiapine 300 mg modified-release and amitriptyline 10 mg daily, and tramadol 50 mg as needed. The patient reported decreasing mobility with increasing back pain, ...

Background: The plurihormonal pituitary adenomas represent 10-15% of all functioning pituitary adenoma. Mixed Growth hormone and prolactin secreting adenomas are the commonest one, approximately 5% of surgically removed adenoma. Other hormonal mixture of adenoma may occur, but very rare. We present a rare case of co-secreting TSH and GH adenoma. Clinical Case: A 45 year old gentleman, generally fit and well, presented with 3 years history of blurred visi...

Introduction: Lymphocytic hypophysitis(LH) is a rare autoimmune endocrinopathy that causes pituitary gland inflammation, resulting in hypopituitarism. Headache is the most common presenting symptom; however, diabetes insipidus (DI) may be the first feature in some patients. Here we report one such case. Case: a 36-year-old female was referred to the Endocrine clinic with sudden onset of polydipsia, polyuria and nocturia. She also reported amenorrhoea but...

47 year old gentleman referred to Neurosurgery Department with incidental findings of pituitary macroadenoma with chiasmal compression and cavernous sinus involvement, whilst getting investigated for tinnitus. His past medical history included chronic migraines only. He has been experiencing increased frequency of migraines along with lethargy, decreased libido and loss of morning erections for some time prior to presentation. His formal visual fields showed a slight inferior ...