Endocrine Abstracts

Case history: This 27 year female was first seen at GSTT in 2012, having had treatment for acromegaly due to a presumed GH-secreting adenoma in 2007 (Trans-sphenoidal surgery × 2, EBRT (2007), pegvisomant (2007-2012 (discontinued due to adverse effects)), & GammaKnife SRS (2011). GH and IGF-1 remained elevated and further treatment with pegvisomant/ SSA was declined. Abnormal bone growth with jaw and skull asymmetry was evident from age 10 years and final height was 1...

Section 1: Case history: A 39-year-old Asian lady at 18 weeks of gestation, after in vitro fertilisation pregnancy, was found to have an adjusted calcium level of 3.08 (range 2.20-2.60 mmol/l) on routine blood tests. She was asymptomatic. Her Parathyroid hormone (PTH) was 14.1 (1.1-6.9pmol/l) and 25 hydroxy vitamin D 16 (15-174 nmol/l). She had insulin treated diabetes following an episode of pancreatitis for which no cause was identified. She was treated as an inpati...

Case History: 41-year-old female presented with a 3-day history of fever, cough, and breathlessness. She had palpitations, diarrhoea and weight loss of 4-5 kg over 1 month. Graves” disease had been diagnosed 5 years prior to this episode and she had been treated with carbimazole but was not in remission. On this occasion, she was febrile and had atrial fibrillation. She also had right pleural effusion and bilateral pedal oedema.Investigations: Blood...

Case History: A 35-year-old was referred to surgery with a confirmed diagnosis of symptomatic acromegaly. Her GH failed to suppress during an oral glucose tolerance test (OGTT), her IGF-1 and prolactin was high. The histology and immunocytochemistry suggested pituitary hyperplasia. We started to look for conditions associated with pituitary hyperplasia resulting in GHRH production, including the genetic tests for inherited conditions. A solitary nodule was noted in her neck du...

Case History: Hyperandrogenism is a relatively common clinical problem. However, severe hyperandrogenism causing virilisation is rare. A 22-year-old lady with no significant past medical history, presented with oligomenorrhoea, hirsutism and male pattern hair loss over last 3 years duration. She has no acne or change in voice or clitoromegaly. She was also noted to be having high BP on clinic visit and grade 1 acanthosis nigricans.Investigations: Her tot...

Case History: An 81-year-old gentleman was brought to A&E by ambulance after being found to be hypoglycaemic at home by paramedics. His wife reported that he experienced unsteadiness and slurred speech after waking up in the morning and she called the emergency number. On arrival of paramedics, his capillary blood glucose was found to be 1.2 mmol/l and he was administered intravenous dextrose. He also had a couple of similar episodes which were resolved with food. He is no...