Endocrine Abstracts

A 20 year old man otherwise fit and well, presented with a seizure, fall and fractured neck of femur. DEXA scan revealed osteoporosis; baseline blood tests were apparently normal in the endocrinology clinic with a Testosterone level of 24.3 nmol/l (Range 9.9–27.8) and normal bone and thyroid profile. He was then lost to follow-up. 4 years on, he was re-referred to the endocrinology clinic with a surprisingly elevated testosterone level of 34.6 nmol/l in combination with o...

: A 78-year-old male with a background of renal cell carcinoma and bilateral adrenal metastasis presented with leg cramps and lethargy. He was on Prednisolone 10 mg od for immune therapy induced pneumonitis. Prior to commencing Prednisolone, he was on Dexamethasone 2 mg for 4 months for weight loss, nausea and vomiting. He underwent a Short Synacthen Test (SST) as his serum Na was low at 119 mmol/L (134–146). His SST showed a flat response with baseline and 30 minutes cor...

A 20-year-old gentleman with an established diagnosis of Chronic fatigue syndrome was admitted to hospital with palpitations and shortness of breath on exertion. He had been taking ‘healthy supplements’ for his ME for a year. On examination, he was noted to be tachycardic with a heart rate of 120–150 beats/minute. ECG confirmed sinus tachycardia. Further investigations revealed a free thyroxine (fT4) of 29.4 pmol/l and thyroid stimulating hormone (TSH...

A 21-year-old female patient was referred from the eye clinic after she was noted to have bilateral papilloedema during a routine eye examination. She gave a 3 months history of intermittent headaches and fleeting episodes of profuse sweating and rash, unrelated to the headaches. She had been investigated by the GP with routine blood tests which were found to be normal.On examination, she was noted to be tachycardic at 100 beats/min and hypertensive at 1...

Optimal management of familial medullary thyroid cancer (MTC) involves early genetic diagnosis of affected individuals and prophylactic thyroidectomy. Patients diagnosed later may have biochemical evidence of metastases which are clinically silent. We report a family which illustrates the management difficulties which may arise with this approach. SC, a healthy 25-year-old man, presented for assessment for MTC. His mother had had a total thyroidectomy for MTC with no clinical ...

Steroid cell tumours are very rare ovarian sex cord tumours that account for only < 0.1% of ovarian tumours. We present an interesting case of a steroid cell tumour in a 17 year old girl referred with worsening hirsutism, weight gain of nearly 3 stones and oligomenorrhea over 2 years. Menarche with regular menstrual cycles was attained at the age of 13 followed by normal reproductive development. On examination, she had an elevated BMI of 33.7 and there was marked hirsutis...

Case history: 81-year-old female patient admitted for fracture neck of femur was referred to endocrinology for high T4. Clinically she was euthyroid with mild thyroid eye disease.PMH: Atrial fibrillation Post CABG 30.09.15, Hypothyroidism since 1983 (started on Eltroxin by GP for weight gain and tiredness though patient never had biochemical evidence of hypothyroidism), OA of spine 2007, T2DM, Asthma.Drug history: Amioda...

Case history: 62 Year old male known to have inflammatory bowel disease, ischemic cardiomyopathy, ICD implant for sustained ventricular tachycardia was referred to endocrine clinic by the GP for thyrotoxicosis which was found on lab workup for worsening diarrhoea and tiredness.Drug historyAmiodarone 200 mg od since 2012, Bisoprolol, Eplerenone, Atorvastain and Pentasa.Investigations: FT4 48.6 pmol/l (6.5&#150...

Introduction: Discordant thyroid function tests are frequently identified in clinical practice and should raise suspicions about laboratory analytical interference.Case report: A 59 year old male was referred to Endocrine services for abnormal thyroid function tests following his recent Emergency department presentation with palpitations. His TFT (Roche) showed FT4 level was raised at 27.1 pmol/l (6.5 - 17.0), and his TSH normal at 2.57 uIU/ml (0.34 - 5....

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...