Endocrine Abstracts

Background: Immunotherapy with checkpoint inhibitors (CPI) {CTLA4 and PD-1 inhibitors} have significantly improved outcomes and survival rates in patients with a number of cancers. In the UK, Ipilimumab and Nivolumab are approved for the treatment of advanced malignant melanoma. These are often long term therapies and are associated with immune mediated endocrinopathies.Case: A 70 year old male presented to the Medical Admissions Unit with a history of l...

A 48-year-old gentleman, father of 3 children, was referred to our endocrinology clinic, with sexual dysfunction and hypergonadotrophic hypogonadism. He had a history of severe Coronovirus-Disease-2019(COVID-19) pneumonitis for which he received prolonged ventilatory support. Post extubation, he experienced testicular pain and swelling. A testicular ultrasound showed a left-sided hydrocele, multiloculated epididymal-cyst and a right testicular cyst. He also described new sympt...

Patient referred to us for Short Synacthen test following, low baseline cortisol in the community, symptoms of fatigue, background history of neck pain on mild opioids, Paracetamol, codeine and Tramadol. Asthmatic on prn salbutamol inhalers. Before attending for Synacthen test patient asked to withhold inhalers and any steroid based medications. Synacthen performed at 08:30am: Pre Cortisol level: 96mmol/lPost Synacthen administration: 388mmol/lInadequate response to synacthen ...

A 41 year old lady was referred to the endocrine clinic by her respiratory physician. She is known to have Langerhans cell histiocytosis (LCH) with lung involvement. She is having yearly follow up under respiratory team and not needing any treatment for LCH. In endocrine clinic she confirmed that she is drinking around 9 to 10 L of water / day and having quite significant polyuria. She works in Tesco. She does not have any other medical condition and not taking any regular med...

32 year old male patient admitted to A&E with a 3 days history of confusion and generalised oedema. History from the mother revealed long standing self-neglect, poor nutrition and prolonged immobility due to abnormal painful sensation and weakness in the lower limbs. This is preceded by a post traumatic drastic change in character of the patient, with resultant agoraphobia and excess consumption of alcohol. Investigations on admission include: TSH 128 ulu/ml (0.27-4.20), T...

Background: We present a case of a 33 year old female with a background of Turner’s syndrome, adequately managed with growth hormone and oestrogen supplementation, Crohn’s disease, horse shoe kidney and subclinical hypothyroidismCase details: She presented to the emergency team with high-grade fever and right sided hemiplegia 10 days following Astra Zeneca COVID vaccination. Initial blood tests showed mildly raised CRP of 49, thrombocytopenia w...

Case Summary: A 53-year-old lady who was normally fit and well, presented with a 3 months history of polydipsia and excessive polyuria up to 13 litres a day. A water deprivation test confirmed a cranial diabetes insipidus, and she was started on desmopressin. Apart from hypothyroidism that was well controlled with levothyroxine replacement, the rest of her pituitary profile was unremarkable for a lady of her age. The rest of her investigations showed persistent increased infla...