Endocrine Abstracts

A 54-year-old man with long standing coeliac disease and moderate dietary compliance was admitted with lethargy and feeling unwell. His blood pressure was 129 mmHg systolic, 91mmHg diastolic and serum sodium 112 millimoles per litre (RR 136 to 145). He was otherwise well with normal visual fields. A 250-microgram Synacthen test demonstrated a basal cortisol of 630 nanomoles per litre rising to 983 nanomoles per litre after 30 minutes. His TSH was undetectable, Ft4 9.6 picomole...

A 22 years old woman presented with a few days history of nausea, vomiting and general lethargy. She was not on any treatment except the oral contraceptive pill (OCP). She was apyrexial, tachycardic at 140/min with a regular pulse and her blood pressure was 110/70. She was not pigmented. Her plasma sodium was 131 mmol/l, with normal potassium, creatinine and urea. Her arterial blood gas analysis showed a pH of 7.22 and bicarbonate of 12mmol/L. Her TFTs showed a thyrotoxic pict...

A 61 year old woman presented with a six months history of nausea, vomiting and lethargy. She is a non-smoker and drinks little alcohol. She was on 100mcg of Thyroxine following partial thyroidectomy. Physical examination was unremarkable apart from postural hypotension (BP 140/80mmHg laying, 105/75mmHg standing). Blood tests showed plasma sodium of 121mmol/L with normal potassium, urea, creatinine, FBC, random glucose and TFTs. A short synacthen test (1mcg) was normal with a ...

Polycystic ovary syndrome (PCOS), which affects 7% of the female population, is associated with established cardiovascular risk factors including obesity, dyslipidaemia and insulin resistance. Thrombus formation represents the final step in the atherothrombotic process and clot structure has been shown to predict the predisposition to cardiovascular events. The aim of the present work was to assess the effects of commonly used therapeutic agents on clot structure and fibrinoly...

A 42 year old gentleman presented for a second opinion regarding management of Congenital Adrenal Hyperplasia (CAH) of the salt losing variety. The patient had been under long term follow up elsewhere but had discontinued his medication of his own accord 14 months prior to seeking consultation. Examination revealed a heavily pigmented male patient with protuberant belly. He had easily palpable masses in both flanks. An abdominal CT showed bilateral massive adrenal enlargement ...

An 18 year old young man was first seen in the ENT department with bilateral swelling of the supraclavicular fossae. A clinical diagnosis of Cushing's syndrome was made and the patient was referred to the Endocrine team. Examination showed a BP of 150/100 and clinical features of gross Cushing's syndrome. Initial investigations revealed normal electrolytes, fT4 8.7 pmol/L, TSH 0.69 mIU/L and a basal prolactin of 68280 mIU/ml. A 24 hr urinary free cortisol (UFC) was 3860 nmol/L...