Endocrine Abstracts

Introduction: Adrenocortical carcinoma is a rare malignancy with an incidence of 1–2 per milion population. We present our experience of three patients with adrenal incidentalomas which were subsequently confirmed to be metastatic adrenocortical carcinoma.Discussion: Our first case presented at 56 years of age with abdominal pain in the background of recent type 2 diabetes and history of alcohol related pancreatitis. CT sh...

Introduction: Adrenocortical carcinoma is a rare malignancy with an incidence of 1–2 per milion population. We present our experience of three patients with adrenal incidentalomas which were subsequently confirmed to be metastatic adrenocortical carcinoma.Discussion: Our first case presented at 56 years of age with abdominal pain in the background of recent type 2 diabetes and history of alcohol related pancreatitis. CT sh...

Case History: 39-year- old female presented to Endocrine services in 2002 with recurrent symptomatic fasting and post-prandial hypoglycaemia. No other medical history of significance noted.Investigations: Short synacthen test, oral glucose tolerance test (OGTT), several supervised 72- hour fasts. Imaging (anatomic and function) included CT A-P, EBUS, Octreotide scan and MRI Pancreas. Results: Short Synacthen test: Basal Cortisol 25...

We report the cases of two identical twins with Graves’ disease which proved very difficult to control and followed very similar stormy course. Twin A was a 20 years old female of 12 weeks gestation when she was referred to endocrine clinic with history of weight loss, palpitations and tremor. Her thyroid function tests revealed TSH <0.08 mU/L (0.03–4.30), FT4 82.5 pmol/L (12–22 pmol/L) and FT3 44.4 pmol/L (2.8–7.1) with positive thyroid receptor antibo...

We report the cases of two identical twins with Graves’ disease which proved very difficult to control and followed very similar stormy course. Twin A was a 20 years old female of 12 weeks gestation when she was referred to endocrine clinic with history of weight loss, palpitations and tremor. Her thyroid function tests revealed TSH <0.08 mU/L (0.03–4.30), FT4 82.5 pmol/L (12–22 pmol/L) and FT3 44.4 pmol/L (2.8–7.1) with positive thyroid receptor ant...

We report the case of a 27 year old female who was referred to our diabetes team from the antenatal clinic, when she was found to have an abnormal glucose tolerance at 16 weeks of gestation (fasting and 2 hours blood glucose values of 5.1 mmol/L and 12.2 mmol/L respectively). At the same time she was suffering with severe hyperemesis gravidarum for many weeks and had suffered significant weight loss (thyroid function tests were unremarkable). She had no specific symptoms to su...

We report the case of a 22-year old woman with aggressive Graves disease. She was initially found to be clinically and biochemically thyrotoxic in June-2001 when she presented with severe thyroid eye disease. Treatment was commenced with carbimazole but she failed to adequately comply with therapy and follow-up appointments. She fell pregnant whilst thyrotoxic and was converted to propylthiouracil (dose gradually increased due to poor response). She then left the area and had ...

We report a 44 year old lady with a history of weight loss, anxiety and ‘prominent eyes’. She was clinically and biochemically thyrotoxic (FT4: 158.1 pmol/L [12–22], FT3:56.5 pmol/L [2.8–7.], TSH:<0.08 mU/L [0.30–4.30]). She was commenced on carbimazole and propranolol. Failure to attend regular clinic appointments or comply with drug therapy over the next few years resulted in huge swings of her thyroid status from severe thyrotoxicosis to profoun...

We report two cases of seizures resulting from severe electrolyte imbalance.Case 1: A 48-year old lady with CREST syndrome and oesophageal dysmotility. She was admitted with diarrhoea and vomiting. Routine investigations including FBC, U&E, LFT, and CRP were normal. She later complained of pins and needles in her hands and around her mouth. Twenty-four hours later, she developed blurred vision, neck pain and generalised ache, was found drowsy, with p...

A 17 year-old female was referred to Endocrinology with primary amenorrhoea and arrested puberty (B4 PH4 AH2). She reported breast development in line with her peer group and had experienced a single “show” of vaginal spotting aged 15 years. Although guidelines recommend baseline pelvic USS in the investigation of primary amenorrhoea, it generally only adds value in females with high LH+FSH and abnormal karyotype; indeed, it may raise undue concerns of uterine (Mulle...