Endocrine Abstracts

Case history: A 41-year-old lady referred to diabetes clinic due to chronic diarrhoea on Metformin and for consideration of any injectable treatment. HbA1c was 41 and BMI is 35. In 2007, OGTT during pregnancy showed fasting glucose of 4.1 mmol/l and 2 h glucose of 7.8 mmol/l. In 2013 her fasting glucose was 7.5 and HbA1c was elevated at 53 mmol/mol. Since July 2013 she has been diagnosed as type 2 DM and started on Metformin. In October 2013 HbA1c fell to 49. Over the succeedi...

Introduction: Hypothalamic obesity can be associated with multiple co-morbidie and is difficult to treatment\. There is little evidence regarding the effectiveness of currently available treatment for weight loss. We looked at the role of bariatric surgery on weight loss in patients with hypothalamic obesity at St George’s Hospital, London.Methods: Six patients with hypothalamic obesity had bariatric surgery. All patients had associated endocrine de...

Background: Oestrogen replacement therapy is essential in transwomen for their well-being. Various forms of oestrogen therapy are available. Individual responses to such replacement therapy may vary. Hormonal implant is a reliable form of hormone replacement in postmenopausal women. However, their efficacy and safety in transwomen have not been thoroughly examined yet.Methods: 14 transwomen had 100 mg of oestradiol implant inserted subcutaneously in the ...

Background: Various forms of testosterone replacement therapy has been used in replacement therapy for transmen and men with hypogonadism. However, efficacy and safety of testosterone implant has not been studied yet.Methods: 11 patietns (five transmen and six men with hypogonadism) had 800–1000 mg of testosterone implant inserted subcutaneously in the anterior abdominal wall. All subjects had previously been on other forms of testosterone replaceme...

A 19 year old girl presented at 39 weeks gestation with headache and blurring of vision. MRI showed an enhancing pituitary mass measuring 1.2 cm maximum height, extending suprasellarly and distorting the optic chiasm. Visual field testing showed bilateral constriction. 0900 h cortisol was 502 nmol/l, thought to be relatively low for the stage of pregnancy and FT4 was 9.3 pmol/l suggesting TSH deficiency. Prolactin was appropriately raised for the gestational age at 4951 mU/l.<...

A 51-year-old asymptomatic man presented in 1998 with elevated thyroid stimulating hormone (TSH) 6.34 mIU/l (0.34–5.6 mIU/l), FT4 54.1 pmol/l (7.5–21.1 pmol/l), FT3 20.1 pmol/l (3.0–5.0 pmol/l) and TSH-α subunits 3.6 mcg/l (<2.0 mcg/l). After the first visit, he was lost to follow-up.He presented 10 years later in 2008 with 1-week history of symptoms of heart failure and hyperthyroidism. Clinically he was thy...

Introduction: Hypothyroidism is a well-recognised cause of macrocytosis, but microcytosis is not widely recognised to be associated with hyperthyroidism. Thyroid abnormalities are often associated with various haematological changes and Graves’ disease has been reported to be mimicking beta thalassaemia trait in the literature. We discuss two cases of microcytosis related to hyperthyroidism that fully resolved once euthyroidism was achieved.Case 1: ...

Background: Cranial Diabetes insipidus (CDI) is a rare condition but is potentially life-threatening if there is a delay or omission of desmopressin. Recent patient safety alerts highlighted the need to raise awareness to avoid mortality and morbidity. The baseline knowledge of the health care professional (HCPs) is very important to avoid deleterious outcomes.Aim: Qualitative survey to determine the baseline knowledge a...

Introduction: Amenorrhea is a frequent cause of Endocrinology clinic attendances. While causes like menopause, thyroid disorders and hyperprolactinemia are common, less common aetiologies need to be considered, especially the inherited ones that could affect a patient’s family. Identifying rare conditions requires constant vigilance, as well as clinical experience and the knowledge of the diagnostic criteria.Case report: We report the case of a 39-y...

Introduction: Anterior pituitary cells are characterised by functional lineages based on the expression pattern of transcription factors. Functional differentiation in the form of pituitary adenomas co-secreting ACTH and growth hormone is very rare. We report a case of multiple cell line pituitary adenoma resulting in acromegaly and ACTH dependent Cushing’s.Case: A 52-year-old woman of Ghanian origin (BMI of 57.5 kg/m2) presented with pro...