Endocrine Abstracts

Introduction: Bardet-Biedl syndrome (BBS) is a rare autosomal recessive genetic disorder involving hypogonadism manifested by cryptorchidism, micropenis and/or delayed pubertyObservation: We report the case of a 13 year old child, who was consulted for obesity and whose physical examination showed major signs of SBB: global obesity, polydactyly, learning difficulties and visual disorders. Genital examination revealed a 1 cm genital tubercle with a single...

This case highlights the importance of investigating for secondary causes of hypertension especially in young people. The patient was referred to exclude Conn’s disease, this case outlines the limitations one may face when interpreting the results of subsequent tests. Miss K was 24 years old when she was initially admitted under the Nephrologists with headache, palpitations and significant hypertension with systolic blood pressure (BP) of 275.Her ec...

A 29-year-old woman was admitted at 33 weeks gestation with pre-eclampsia (BP 145/107 mmHg, 3+ proteinuria and significant oedema). On admission her Na was 133 mmol/l and urinary Na 49 mmol/day (ref range 130–260). Twenty-four hours urine protein was 4.43 g/day. Foetal assessment revealed intra uterine growth retardation. She was started on labetolol and the dose titrated upwards to control her blood pressure.Her serum sodium level gradually fell re...

The frequent use of brain and head MRI/CT has lead to an increase in the number of incidental pituitary lesions reported, so called pituitary ‘incidentalomas’. Such lesions require endocrine evaluation of pituitary function and radiological follow up. We performed a retrospective study to examine the source of these referrals, size of the incidentalomas, frequency of pituitary dysfunction and changes during follow-up. We performed a search of the departmental endocri...

Introduction: Central hypothyroidism is frequently seen after pituitary surgery, radiation therapy or head injury. We present a case of silent thyroiditis in a patient with secondary hypothyroidism. Case Description A 24 year old woman complained of tiredness during her periodic review in the endocrine clinic. Her endocrine history included surgery for craniopharyngioma at the age of 3 years and subsequent hypopituitarism with growth hormone, ACTH deficiency, diabetes insipidu...

Vitamin D is not only essential for maternal health but insufficient levels during pregnancy and breast feeding can lead to infantile rickets or osteomalacia in their offspring. NICE recommends that vitamin D supplements should only be offered to pregnant women with dark skin, those who usually cover their skin, vegans and women between the ages of 19–24. Although it is widely known that these women are at high risk of vitamin D deficiency, the incidence of vitamin D insu...

Introduction: Recent trials suggest that using ergot-derived dopamine agonists such as cabergoline in the treatment of Parkinson’s disease is associated with an increased risk of valvular heart disease. However, the dose of cabergoline used to treat hyperprolactinaemia is considerably less than that used in Parkinson’s disease.Study design: A cross-sectional study; forty four patients, who received cabergoline for at least 6 months, underwent t...

The aim of this retrospective study was to assess hydrocortisone replacement therapy in patients with adrenal insufficiency, by correlating hydrocortisone regimens and doses to that of serum and urine cortisol levels.Method: We studied the case notes of 83 patients, whose records contained the results of at least one valid hydrocortisone day curve and 24 h urine free cortisol level. Twenty-seven patients were on twice daily, and 56 were on thrice daily r...

We report 29 years old female with recurrence of adrenal carcinoma and hypercortisolism secondary to HCG responsive adrenal carcinoma.which has been surgically excised in 2003 following the birth of a live infant at 28 weeks gestation.A year latter she presented with a tenderness over the right rib cage and had CT scan which showed metastases at the liver and right renal bed.Hypercortisolism was confirmed biochemicaly with a 24 hou...

Introduction: The short synacthen test (SST) is commonly used to assess the hypothalamic pituitary adrenal (HPA) axis in clinical practice. We evaluated the underlying clinical conditions pre-empting the request for a SST in a general medical ward and the adequacy of clinical follow up of patients with suboptimal responses to the test.Methods: All patients with suboptimal SST results (30 min cortisol level 450–540 nmol/l) performed in the Acute Asse...