Endocrine Abstracts

Case History: Case 1: A 37-year-old lady with relapsing-remitting multiple sclerosis was initiated on Alemtuzumab and symptoms of sweats and heat intolerance arose. Hyperthyroidism was confirmed with free T4 30.1 pmol/l (12–22) and suppressed TSH. Symptoms settled without antithyroid medication and within 2 months T4 had fallen to 10.2 pmol/l with TSH 6.95 mIU/L. After a further 6 weeks T4 was 9.8 with TSH 20.35 and levothyroxine was initiated. Anti-TPO was raised at 442 ...

A 26yr old man presented to haematology with a short history of easy bruising. There was no spontaneous bleeding. Past medical history was unremarkable. Family history of clotting disorders was negative. On examination there was significant lower limb bruising.Initial investigations revealed platelets of 238 (150–450), prothrombin time (PT) of 12.0 (12.0–17.0 s) and elevated activated partial thromboplastin time (APTT) of 41.0 (24.0–38.0 s...

Hypopituitarism usually is the result of a pituitary tumour or its treatment. If, however, pituitary imaging is negative then an alternative diagnosis should be sought. We present two patients initially diagnosed as idiopathic hypopituitarism in whom the underlying diagnosis was delayed with potentially serious consequences.The first case was of a 32 year old male who presented with symptoms and signs of hypogonadism. Serum testosterone (<0.7 nmol/L)...

A 39-year-old female presented with an 18-month history of borderline hypertension, headaches, palpitations and some anxiety symptoms. Both parents also had hypertension. Blood pressure was 160/102 on no medications. She had a large single cafe au lait spot but no neurofibromata. Urinary dopamine levels were repeatedly elevated (5398–8653 nmol/24 h (n<3900)) with normal noradrenaline and adrenaline levels. Serum calcium was also elevated at 2.83 mmol/l (n...

Pituitary surgery frequently leads to one or more anterior pituitary hormone deficiencies but the incidence of GH deficiency is unclear. The aim of our study was to establish the incidence of GH deficiency in patients post hypophysectomy. Current NICE guidelines recommend GH replacement in severely GH deficient patients who have one or more other pituitary hormone deficiencies and diminished QoL by AGHDA.Thirty-five patients (M:F 15:20; age range 23&#150...