Endocrine Abstracts

Case history: A 51-year old female presented to emergency with occipital headache for 5 days on a background of recurrent headaches for over a year. She had been diagnosed with Hashimoto’s disease at the age of 30 and given levothyroxine, which she discontinued 5 years ago due to aversion to take medications. She had noticed cold intolerance and low energy. At presentation her body mass index was 25.26 kg/m2 and the physical exam was unremarkable; specifically,...

The role of environmental and occupational toxins in the aetiology of unexplained infertility remains to be fully explored. Epidemiological studies have implicated heavy metals, including cadmium as having a pathogenic role with studies demonstrating associations between serum levels, testicular function and gonadotrophin levels in large cohort studies. Cadmium toxicity is associated with a complex spectrum of effects. Whilst the renal complications are well described, putativ...

Background: There is a well-documented relationship between lithium exposure and thyroid dysfunction via multiple mechanisms. Lithium is commonly associated with goitre, hypothyroidism, and subclinical hypothyroidism. Lithium-induced autoimmune hyperthyroidism is rare and poorly understood. We report a case of autoimmune thyroiditis, Graves’ disease (GD), in a patient with longstanding primary hypothyroidism believed to be induced by Lithium.<p class=...

Pheochromocytoma crises are uncommon but have high mortality. We describe herein a case where multidisciplinary team management was crucial in safely carrying the patient through such a crisis. The patient was a 63 year old lady with a background of neurofibromatosis type 1 (NF-1), and previous renal artery stenosis bypass surgery. She was admitted via A&E with increasingly frequent episodes of sweating, headache, dyspnoea and palpitations. Her troponin was raised at admis...

Introduction: Causes of Primary Congenital Hypogonadism in Males are Leydig cell Agenesis, Cryptorchidism, Chromosome abnormalities (e.g. Klinefelter syndrome, SRY positive 46 XX etc), Enzyme defects include 5α-reductase deficiency. Acquired Primary Hypogonadism includes Testicular torsion, Orchidectomy, Chemotherapy/Radiation toxicity, Orchitis, CKD, Cirrhosis, Sickle cell disease, etc. SRY (SEX determining region Y) is regulatory gene located on Y chromosome and is resp...

Introduction: Common causes of generalised seizures are epilepsy, meningitis, head injury and hypoglycaemia. But this is an unusual presentation of generalised seizures secondary to hypocalcaemia due to prolonged use of PPI’s. PPI’s are amongst the most commonly prescribed drugs due to their effective medicinal profile. They are generally well tolerated, however, are now increasingly reported to be associated with adverse effects. There has been some discrepancy abou...

The guidelines for management of prolactinomas (PRLoma) during pregnancy are mostly based on retrospective evidence or expert opinion. We conducted a survey of four Canadian provinces (NS, NB, PEI and BC) to assess the current trends in management of PRLoma during pregnancy. A case-based electronic questionnaire was sent to all practicing endocrinologists, with 3 cases of varying severity ranging from a micro PRLoma to a large macroPRLoma compressing the optic chiasm. A total ...

Background: With increasing ethnic diversity in the Western World, it is important to establish the safety of religious practices such as fasting during Ramadan. There is limited information about severity and outcome of diabetes-related ketoacidosis (DKA) during Ramadan outside Middle East.Objective: We studied differences in severity, DKA-related complications and outcomes of DKA before (Shaban), during (Ramadan) and after Ramadan (Shawwal).<p clas...

Diabetes mellitus type 2 (DM-2) is a disorder characterized by high blood glucose levels in the context of insulin resistance and relative insulin deficiency. DM-2 is typically an outcome of combinations of hereditary elements of impaired insulin release and insulin resistance, and natural variables like obesity, overeating, absence of activity, aging and stress. A number of hormones, such as cortisol and growth (GH), have insulin-antagonistic effects. Cortisol is a predominan...

We recently developed a visual scale to assess the extent of morphometric changes in Acromegaly (Acro) patients which is strongly predictive of adverse psychological outcomes. We sought to identify if there was any association between the self-drawing test and the visual morphometric scale and if there was any correlation with psychological outcomes.We compared 60 consecutive non-functioning adenoma (NFA) and Acro patients who had undergone pituitary sur...