Endocrine Abstracts

Patients with diabetes are prone to peripheral vascular disease. We present the case of an 81 year old female, current smoker who presented to her general practitioner with a 3 day history of ankle oedema for which she received furosemide. She had a background of right above knee amputation due to peripheral vascular disease and essential thrombocythaemia. Five days after commencing furosemide, she developed increased lethargy and confusion. On arrival to hospital, her venous ...

This 23 years old man was noted incidentally to have bilateral adrenal calcification on CT scan of his abdomen for chronic abdominal pain. He had normal growth and milestones with no neonatal events. Aged 10 years he was admitted briefly to a high dependency unit with circulatory shock and hyperthermia, with isolation of Streptococcus mitis from blood culture. One year later he was noted to have bilateral adrenal calcification on abdominal XR, and a short Synacthen (250 μ...

Background: Letrozole is a potent aromatase inhibitor licensed for use in women with breast cancer. It is also used by body builders for reduction of gynecomastia when taking anabolic steroids. Supply for this unlicensed use is readily available through internet. Testosterone production is regulated by negative feedback of estrogen on the pituitary. The use of letrozole can therefore cause supraphysiological levels of testosterone in men. We present such a case.<p class="a...

Background: Primary Hyperparathyroidism is mainly produced by an adenoma and it is mostly a benign condition. Most of the patients are asymptomatic. We present a case of ectopic parathyroid cyst presenting with this condition.Case: A 76 yr female presented with new onset confusion, abdominal pain, vomiting, diarrhoea and dehydration. She was currently being treated for a urinary tract infection. Investigations showed acute kidney injury with creatinine 3...

Objectives: Increasing use of scanning has led to a significant increase in detection of adrenal incidentalomas. The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons have issued guidelines for evaluation of adrenal incidentalomas in 2009. We audited our current practice at Royal Shrewsbury Hospital against the 2009 guidelines.Method: Retrospective audit of patients found to have adrenal masses on imaging st...

Background: Primary hypoadrenalism with bilateral adrenal enlargement is a relatively rare condition. We present four such patients. Case 1: 60 year old male presented with malaise, weight loss and hyponatremia. Short synacthen test was abnormal and ACTH was raised (309 ng/L). CT adrenals showed bilateral adrenal enlargement with uniform texture and low attenuation with no change in repeat CT. FNAC of adrenal gland showed infarcts. Further tests confirmed antiphospholipid anti...

Introduction: We present a case of Dunnigan Kobberling type of lipodystrophy in a young female.Case report: A 25-year-old woman presented with hirsuitism, secondary amenorrhoea, increase in neck size and reduction in breast size. On examination she had moon like facies, broad neck, small breasts and well defined male pattern musculature. Testosterone and lutenising hormone were marginally raised, serum alanine transminase was raised. Overnight dexamethas...

Background: Post menopausal hirsutism should raise suspicion of androgen secreting tumors. We present a case due to bilateral ovarian hyperthecosis with an adrenal incidentaloma.Case history: 57 year old female patient was referred to us with history of new onset hirsutism over the past 2 years. She went through menopause 6 years back. On examination she had hirsutism affecting all her body, no evidence of virilization and no organomegaly on abdominal ex...

A 63-year-old phenotypic male presented with absent testis and enlarged adrenal glands. He had attended the urology clinic for persistent microscopic haematuria. He was found to have an empty scrotum and hypospadias. The patient recalled having genital surgery in childhood but could not recall any endocrine assessment. He was taller than his peers in early childhood but stopped growing after age 13 years. He described himself as ‘potent’. He was unmarried and did not...

Introduction: Aminoglycoside exposure may result in hypomagnesemia, hypocalcaemia and hypokalemia. We describe a case of severe hypomagnesemia due to gentamicin therapy.Case report: A 46-year-old lady presented with ‘pins and needles’ and muscle cramps two weeks after being treated with gentamicin for biliary sepsis. Trosseau and chovstek signs were positive. Investigations showed hypokalemia, hypocalcaemia and hypomagnesemia (0.25 mmol/l (0.74...