Endocrine Abstracts

An 82 year old man was admitted to hospital with lethargy, anorexia and back pain. His past medical history included chronic lymphocytic leukaemia and hypertension. Blood tests revealed a serum sodium of 115 mmol/l and potassium of 5.4. His irbesartan was discontinued and sodium rose to 126 prior to discharge. 9 am cortisol was 408 nmol/l. He was readmitted to hospital 6 days later with hyponatraemia (116 mmol/l). A short Synacthen test was performed which showed a flat respon...

Adrenal haemorrhage is comparatively rare. A 64-year-old female presented with acute right sided abdominal and chest pain shortly after a left knee replacement. She had recently started treatment dose low molecular weight heparin for presumed DVT for persistent pain in the left knee. A subsequent Doppler study of left leg was negative for DVT but an abdominal US revealed a solid lesion at the upper pole of the left kidney. CT urography showed large bilateral adrenal masses. No...

Case History :A 34-year-old Caucasian female patient presented in May 2015 to A&E with symptoms of overt thyroid dysfunction. She was managed medically until June 2016 when thionamide treatment was withdrawn. Unfortunately, this lady had a first disease relapse in July 2018 whilst she was pregnant at 35 weeks of gestation and then further disease relapse in January 2020 during her second pregnancy. Investigations: Initial biochemistry in 2015 confirm...

Case history: A 49-year-old teacher presented to his GP with lethargy and lower limb weakness. He had noticed polydipsia and polyuria, and had experienced weight loss albeit with an increase in central abdominal fat mass. He had previously undergone cholecystectomy and colonic polypectomy. He took no regular medications. Investigations: He had hypercalcaemia 3.34 mmol/l with PTH of 356 ng/l and hypokalaemia 2.7 mmol/l and was admitted for intravenous flu...

A 46 year old female presented with 12 months history of secondary amenorrhoea. Prolactin was 4746 mIU/l without macroprolactin complexes, LH & FSH were low, oestradiol was undetectable. She had normal visual fields. No other clinical or biochemical features of pituitary dysfunction. She had no regular medication. Pituitary MRI was normal. She was started on cabergoline 250 mcg twice weekly which was subsequently increased to 500 mcg twice weekly. Repeat serum prolactin 5 ...

Introduction: Moderate hyperprolactinaemia occurring in a patient with a normal pituitary MRI, assuming macroprolactin and stress are excluded, is generally considered to be due to a lesion below the level of detection of the MRI scanner. Most patients with mild-moderate hyperprolactinaemia and a normal MRI respond to dopamine agonist therapy. We describe a patient who had prolactin elevation typical of a prolactin-secreting macroadenoma, but with a normal MRI, and in whom the...