Endocrine Abstracts

18 year old female was referred to endocrinology from Paediatric and adolescent gynaecology with secondary amenorrhea. She had her menarche at age of 15 years with profuse bleeding for three days only, no spontaneous periods afterwards. She had no symptoms of weight gain, increased hair growth, galactorrhea, headache or any skin changes. She had significant history of hair loss. She had normal milestones. She achieved her adrenarche and thelarche at age of 12-13 years. Family ...

Primary hyperparathyroidism (P-HPT) is one of the most common of all endocrine disorders. 80 to 85% of cases are due to parathyroid adenomas while hyperplasia accounts for 10% to 15% and carcinoma less than 1%, of cases.1 Its very rare for parathyroid adenoma to present with clinically severe hypercalcaemia or a ‘parathyroid crisis’. There are some existing case reports.2,3 We report a case of a 67 year old woman who presented with severe irrita...

A 57 year-old female patient was admitted for the supervision of supplementary parenteral feeding, due to excessive weight loss and difficulty with gastric motility since having Roux-en-Y gastric bypass surgery a decade ago. During her stay she was noted to have regular episodes of significant resting hypotension, postural hypotension, and tachycardia, which did not respond to fluid replacement or nutritional support. Endocrinology specialist advice were requested by her gastroe...

73 year old lady with metastatic pancreatic cancer referred to diabetes clinic with worsening of her diabetes control. She was primarily under care of Gastroenterology department, for her symptoms of weight loss, abdominal pain, diarrhoea, sweating and anaemia. Her scan showed metastatic pancreatic cancer arising from tail of pancreatic with metastasis to liver. The liver biopsy of secondary liver deposit was not conclusive. She had borderline diabetes at her presentation wors...

We present a unique case of Pembrolizumab induced adrenal insufficiency. A 65 year old lady was admitted with septic shock secondary to chest infection. She was 3 weeks post neo adjuvant chemotherapy plus immunotherapy for triple receptor negative solitary Right sided breast cancer. She has Type II Diabetes mellitus, hypercholesterolemia and varicose veins. She takes Metformin and Atorvastatin. She is single, with no significant family history. On intravenous antibiotics her b...

Steroid cell tumours are very rare ovarian sex cord tumours that account for only < 0.1% of ovarian tumours. We present an interesting case of a steroid cell tumour in a 17 year old girl referred with worsening hirsutism, weight gain of nearly 3 stones and oligomenorrhea over 2 years. Menarche with regular menstrual cycles was attained at the age of 13 followed by normal reproductive development. On examination, she had an elevated BMI of 33.7 and there was marked hirsutis...

Background: While investigating hyperandrogenism in women, local laboratory policy dictates adult females with a serum testosterone of >3.5 nmol/l should be confirmed with an alternative method to exclude interference by cross-reacting substances. Patients who were on testosterone replacement or had a previous result in the same year were excluded. We explore the biochemical investigation of discrepant testosterone in females.<strong...

21 year old man presented to the emergency department with hypotensive shock. He had been seeing the GP with complains of poor appetite, intermittent vomiting, increased thirst and postural dizziness for the last 6 months. Previous medical history included tonsillitis, gastritis and learning difficulties. The working differential was severe gastroenteritis with hypovolemic shock, and so he was given immediate fluid resuscitation. He remained hypotensive, and so was given empir...

Pheochromocytoma is a rare disorder of chromafin cells and can be incidentally found in 20% of adrenal masses. It can be malignant in upto 10% of the cases. Metastatic disease poses a great challenge and no definitive cure is yet established to treat these tumors.We report a case of 54-year-old male patient with past medical history of anxiety who presented with acute left sided abdominal pain to the urology department at Norfolk and Norwich University H...