Endocrine Abstracts

A 44 year old lady presented with weight loss to the gastroenterologists and a CT abdomen done picked up a mass below the pancreas. She underwent a percutaneous biopsy of this mass and the histology revealed a paraganglioma. She was referred to the endocrinology team. Subsequent questioning revealed coexistent symptoms of cataecholamine excess and plasma metanephrines of 4825 pmol/l and plasma normetanephrines of 166 pmol/L gave biochemical confirmation. MIBG scan showed a dir...

Kallmann syndrome is a treatable form of male infertility caused by a congenital defect in the secretion or action of gonadotropin releasing hormone (GnRH). It can permanently remit in around 10% of male cases. We report a patient with atypical Kallman’s syndrome who requires intermittent testosterone replacement to sustain activity of his gonadotrophic axis A 55 year old male presented with erectile dysfunction and decreased libido. He reported normal puberty, with no hi...

Fifty year-old year old gentleman presented unwell whilst on holiday with headache and vomiting. He also reported a clear fluid trickling down his nose. On examination he was pyrexial, photophobic and had demonstrable neck stiffness. Lumbar puncture and a subsequent culture confirmed streptococcal meningitis which responded to antibiotics.His CT scan head suggested a pituitary mass and a subsequent MRI revealed an unusual massive pituitary tumor extendin...

Background: The treatment of choice for symptomatic primary hyperparathyroidism (PHPT) is surgery, however in many cases patient choice or medical comorbidities preclude this treatment modality.Aim: This audit examines the use of cinacalcet in management of primary hyperparathyroidism in a district general hospital to determine if it is in accordance with the National institute for health and care excellence (NICE) guidance (May 2019).<p class="abste...

Background: National osteoporosis guideline group recommend routine measurement of thyroid function tests. However it is well recognised that abnormal thyroid function tests done during acute hospital stays is not always suggestive of thyroid dysfunction and that they need to be repeated to determine the need for further management.Aim: To identify and assess the follow up of thyroid function tests (TFTs) done between June 2009 and Feb 2010 in the orthop...

Background: Functional hypogonadotrophic hypogonadism (FHH) occurs in the context of any chronic disease including obese patients with type 2 diabetes (T2DM) and/or metabolic syndrome. FHH is reversible with resolution of the underlying disease process. Reported benefits of bariatric surgery include improvements in lipid profile, blood pressure and resolution of T2DM. Here we report reversal of FHH and T2DM with bariatric surgery-associated weight loss.C...

Background: Hypogonadotropic hypogonadism in apubertal males is commonly due to constitutional delay; permanent gonadotropin deficiency becomes more likely with older age at presentation, cryptorchidism and non-reproductive defect, e.g. anosmia. All forms of testosterone induce pubertal development, though short-acting IM preparations are associated with extraphysiological excursions of serum testosterone and are increasingly unavailable. Long-acting testosterone undecanoate I...

Background: Routine measurements of serum calcitonin levels are considered an integral part of the diagnostic evaluation of medullary thyroid cancer (MTC). We report a rare case of calcitonin and carcinoembryonic antigen (CEA) negative MTC.Case presentation: A 63-year-old retired plasterer attending a well mans clinic was referred to the endocrinology service with elevated calcium (2.75 mmol/dl). Systemic examination was unremarkable and there was no end...

Introduction: Diabetes insipidus can complicate up to 1 in 30 000 pregnancies and has a variety of causes, some that predate the pregnancy and others that begin during gestation. In addition, women can experience diabetes insipidus de novo in pregnancy through the actions of placental vasopressinase, which causes accelerated degradation of vasopressin. This form of diabetes insipidus may be associated with increased complications of pregnancy, including pre-eclampsia. M...

Medullary thyroid cancers (MTC) account for about 5% of thyroid cancers. The biochemical hallmark of MTC is the secretion of calcitonin (CT). CT levels are both a key feature of pre-operative diagnosis and post-operative follow up. CT screening in a cohort of over 10 000 patients with thyroid nodular disease has demonstrated that a positive CT test has a higher diagnostic sensitivity and specificity for MTC than fine needle aspiration (FNA). They may also secrete carcinoembryo...