Endocrine Abstracts

Case history: A previously well 45-year-old lady presented with a 3-year history of hypertension initially diagnosed at a routine health check. Her blood pressure (BP) was 170-180/90-100 mmHg.Investigations: Showed hypokalaemia (K+= 3 mmol/l; NR 3.5-5.3 mmol/l), raised aldosterone (976pmol/l; NR 100-500pmol/l) and supressed renin activity (<0.2nmol/l/h), meeting criteria for diagnosing primary aldosteronism (PA). CT adrenals showed a 2.5 cm left adre...

Background: Pituitary abscesses are rare and carry a high mortality risk. Recurrence of such abscesses is even rarer, with only 9 cases previously reported in the literature to our knowledge. We describe a case of a recurrent pituitary abscess, felt to be associated with inflammatory bowel disease. Case history, investigations, results and treatment A 27-year-old female presented with a right 6th nerve palsy associated with a 3-month history of headache post-partum. Further in...

Section 1: Case history: Persistent hyperinsulinemic hypoglycaemia may be caused by either a solitary tumour of the pancreas secreting excessive insulin, i.e. an insulinoma or, rarely by nesidioblastosis. A 70-year-old man was referred with symptoms of hypoglycemia. He had a positive 72-hour-fast with episodes of hypoglycemia and high insulin levels. Section 2: Investigations: EUS showed a small 3 x 4mm hyperechoic lesion in the body of the pancreas. His...

A 29-year-old man presented with an 18-month history of reduced libido and lethargy. His symptoms started after cessation of anabolic steroids for three years. His childhood and development history were unremarkable with normal onset of puberty and development of secondary sexual characteristics. He had no past medical or family history of note. Clinical examination demonstrated normal BMI, musculature, distribution of body hair, testicular volume, and genital size. Biochemica...

A 51-year-old gentleman presented in June 2022 with pneumobilia, staph liver abscesses and rapidly conducted atrial fibrillation requiring ITU admission. He had a 2-year history of typical Cushingoid features and hypogonadism, 4 agent hypertension since 2012, fragility fractures, previous renal calculi, pulmonary emboli and diabetes. He had not been able to walk unaided for a year (was mobilising with crutches on admission). In retrospect, he had previously had a cortisol of 7...

Case History: A 47 year-old female was referred to the Endocrine Bone Unit with worsening back, rib and leg pain associated with significantly reduced mobility. In the preceding year, she had repeatedly presented to healthcare providers with no clear neurological deficit, no fractures identified on X-Ray and normal MRI appearances of the whole spine. Aside from well-controlled asthma and gestational diabetes, she had no significant past medical, medication, social or family hi...

Section 1: Case history: A 23-year-old female presented to the Emergency Department with a 3-month history of intermittent chest pain and palpitations. She was found to be hypokalaemic and hypocalcaemic. On direct-questioning she reported 3 weeks of perioral paraesthesia and muscle spasms. She had an unrestricted diet and no other personal or family history of note. She was normotensive with a sinus tachycardia and normal QT-interval, Chvostek’s negative, with no features...

Background: Bruns Garlands syndrome is a rare disorder in people living with diabetes, manifesting as unilateral or bilateral muscle pain, weakness and atrophy in the proximal region of the lower limbs. Herein, we present the case of a patient with Bruns-Garland syndrome caused by sodium/glucose co-transporter 2 inhibitors (SGLT2i).Case description: A 55-year-old male with background of type 2 diabetes for 5 years, and currently on oral therapy, presente...

Case history: We present a case of 36Y old male who presented with worsening leg edema, leg ulceration and poor mobility leading to admission in intensive care due to sepsis and hemodynamic instability. Found to have metabolic alkalosis with hypokalaemia. Clinically, moon-like facies, low proximal muscle mass, skin hypopigmentation (mainly hands), broken skin fingers and legs, abdominal fat distribution. Investigations:Random cortisol 2348nmol/l, post 1mg dexamethasone cortiso...

Case history: A 33 year old lady with irregular menstrual cycles and infertility presented to gynaecologist with recurrent abdominal pain and bloating. Her pain was found secondary to bilateral ovarian cysts. She had repeated laparoscopic ovarian cystectomies since 2018. In December 2021, modest hyperprolactinemia (1065MIU/L, RR 102-496) with negative macroprolactin test was noted, and MRI pituitary revealed 18x17x13mm pituitary macroadenoma. Cabergoline was started and she wa...