Endocrine Abstracts

Although mature skeletal muscle fibres are viewed as post-mitotic cells, they possess the ability to regenerate in pathological situations. Regeneration is mediated by satellite cells, which under appropriate conditions, will proliferate, then fuse and finally participate in the formation of regenerated fibres. Other cell types, including stem cells harvested from varied tissues, also fulfil the satellite cell role under certain conditions. Recent research has centred on ident...

Lymphocytic hypophysitis is a rare inflammatory disease of the pituitary gland. The aetiology is unknown though probably of autoimmune origin.We report the case of a 40 year-old woman who presented 39/40 weeks pregnant with an inferior bitemporal homonymous quadrantinopia. She had primary hypothyroidsim and had had previous unsuccessful in-vitro fertilisation, though this conception was spontaneous. Magnetic resonance imaging (MRI) demonstrated a large p...

Pretibial myxoedema (thyroid-associated dermopathy), an extrathyroidal manifestation of Graves disease, is a localized thickening of the skin due to accumulation of acid mucopolysacharides (glycosaminoglycans). Almost invariably, pretibial myxoedema occurs in the presence of ophthalmopathy.We report the case of a 57-year-old man of North African origin, who presented with pretibial myxoedema as the first manifestation of Graves disease. He was admitted w...

A 43-year-old lady with no significant PMH presented with recent onset of polyuria and polydypsia shortly after commencing an SSRI. Cranial diabetes insipidus was diagnosed on water deprivation test and good clinical response to DDAVP was seen. Anterior pituitary function was normal though prolactin elevated. MRI demonstrated a 4 mm enhancing lesion in the hypothalamus in association with a bright pituitary stalk. CXR was normal, ESR and serum ACE negative. The differential di...

We present the case of a 70 year-old man who presented with several months history of tiredness and lethargy. He had a past medical history of ischaemic heart disease. Examination identified a bitemporal hemianopia. Initial investigations demonstrated hyponatraemia, sodium 117 mmol/L (Reference range 132–145) with normokalaemia. Further investigations confirmed hypopituitarism: Short Synacthen Test Cortisol at T=0 min, 125 mmol/L, Cortisol at T=30 mins, 277 mmol/L, free T...

Brown tumours (osteitis fibrosa cystica) are the classic bone disease of hyperparathyroidism. Parathyroid carcinoma is an uncommon cause of PTH dependent hypercalcaemia. We present the case of a 63-year-old man who presented to the ENT department with persistent right-sided nasal obstruction and nasal swelling. He was otherwise asymptomatic. He had a long history of nasal polyps, which had recently been resected. Brown’s tumour of the maxilla was demonstrated on nasal bio...

Thyroid cancer is rarely seen in the hyperthyroid patient.We present the case of a 59 year-old lady who presented with marked weight loss of more than 30 kg in less than 6 months, lethargy, palpitations and sweats. Clinically she was obese and thyrotoxic with sweaty palms and a tachycardia. No goitre or neck masses were detected. Thyroid function tests confirmed thyrotoxicosis with free T4 89.1 pmol/l (Normal range 9.8–23.1), free T3 20.2 pmol/l (No...

Aim: Acute bouts of exercise are known to have a beneficial effect on glucose homeostasis immediately following exercise in people with Type 2 Diabetes. Evidence suggests that this effect is independent of the effects of insulin. In this study we compare recently developed indices of insulin sensitivity derived from the oral glucose tolerance test to determine whether the improvements in glucose homeostasis following physical activity are independent of the effects of insulin....

Primary adrenal failure is a rare disorder with a prevalence in developed countries of 93–140 per million and an incidence of 4.7–6.2 per million. Autoimmune adrenalitis is the main cause (80%) followed by tuberculosis (15%). The remaining 5% of cases represent rare disorders with bilateral adrenal haemorrhagic infarction secondary to primary antiphopholipid syndrome being very rare (0.5%).A 57-year-old female presented with a 3-week history of...

Gynaecomastia is common, occurring in 30–50% of healthy men, and its aetiology is usually benign. Clinical features inclusive of recent onset, rapid progression, and loss of libido and muscle strength, indicate the need to exclude a malignant aetiology.A 48-year-old man presented with an 18-month history of such clinical features. Investigations revealed cortisol 1136 nmol/l, 17-hydroxyprogesterone 6.6 nmol/l, androstenedione 13.3 nmol/l, DHEAS 21.8...