Endocrine Abstracts

A 74 years old man was referred to endocrine clinic with abnormal TFTs with raised free T4 (39.7 pmol/l; NR: 7.0–17 pmol/l), raised FT3 (7.3 pmol/l; NR: 3.5–6.5 pmol/l) and normal TSH (1.9 mU/ml; NR: 0.35–5.5 mU/ml) which were done on routine testing by his GP. PMH included COPD and B12 deficiency. He had no symptoms suggestive of thyrotoxicosis and was clinically euthyroid. Investigations were arranged to exclude the three possibilities of assay interference, R...

Background: Congenital adrenal hyperplasia (CAH) is an autosomal recessive condition with significant consequences if not correctly diagnosed and treated. We have reviewed the patients with CAH presenting in Northern Ireland between 1976 and 2010.Aims: To determine the age, sex and clinical features at presentation; treatment modalities including perineal surgery in childhood; and long-term outcomes including final height and surgery in adulthood.<p ...

Transformation of a micro-prolactinoma to a macro-prolactinoma during pregnancy is rare. During treatment of micro-prolactinoma it is conventional to stop dopamine agonist treatment prior to or at conception and only re-image the pituitary if the patient presents with symptoms or signs of pituitary enlargement. We present two cases of micro-prolactinoma transforming to macro-prolactinoma during pregnancy. Neither case presented with symptoms or signs of pituitary enlargement. ...

Background: Cabergoline-associated valvulopathy (CAV) is an established complication of cabergoline therapy in Parkinson’s disease, with a definitive echocardiographic triad of severe regurgitation, leaflet thickening, and restricted valve movement without calcification. Long-term cabergoline therapy is deemed safe for prolactinoma due to low dosage. We describe the first UK case report of aortic regurgitation (AR) associated with low-dose cabergoline in prolactinoma....

A 24 years old veterinary nurse presented to the cardiology outpatient clinic with palpitations, breathlessness and lethargy. There was no history of weight loss. She had a past history of bulimia. She was clinically euthyroid. ECG demonstrated sinus tachycardia with heart rate of 120 bpm. Thyroid functions test (TFT) done by GP was normal. She was initially treated with beta-blockers.She was subsequently admitted to hospital a month later with palpitati...

Introduction: Isolated eosinophilic pancreatitis is very rare disease and usually occurs either as hyperoesinophylia syndrome or as part of eosinophilic gastroenteritis.Case report: A 55-year-old man presented to his general practitioner (GP) with a 3 week history of flu-like symptoms, pruritis, weight loss and diarrhoea. Initial investigations showed eosinophilia (32.2 ×109/l) and a normal random glucose.He was see...

We present the case of a 27-year-old man who was first diagnosed with type 1 diabetes mellitus when he presented with diabetic ketoacidosis (DKA) and during later admissions was found to have grossly abnormal liver function tests. Following diagnosis, his diabetic control has been a challenge to manage despite the patient’s claim he had been taking his insulin ‘religiously’. He has had repeated admissions with DKA and has failed to attend clinic follow-ups on se...

A 36 year-old female presented with increasing headaches over the previous 8 months. She had seen in the neurology clinic recently and treated for migraines and cluster headache. She also had a history of depression. She had prodromal aura of visual disturbance including blurred vision and photophobia.She was admitted following sudden onset of stabbing pain over the left eye along with nausea. All these symptoms were classic of her usual migraines. On ad...

Background: One percent of the adult population are, at any one time, prescribed oral glucocorticoids (GC). GCs are known to be associated with hypothalamic–pituitary–adrenal axis suppression. However, there remains uncertainty regarding: i) the prevalence of GC-induced adrenal insufficiency (AI); ii) the effects of GC dose and duration; and iii) the time course of adrenal recovery and how GCs should be withdrawn. We undertook a systematic literature review to addres...

Introduction: The hCG stimulation test is a useful indicator of functional testicular tissue and may also have a place in treating undescended testes (UDT). However, its utility is limited by the inconsistency in the regimens used. We have looked at the clinical and biochemical response in a group of children with UDT who had a prolonged hCG stimulation as part of their clinical management.Methods: The retrospective review in 17 cases with a median EMS (...