Endocrine Abstracts

47 year old gentleman referred to Neurosurgery Department with incidental findings of pituitary macroadenoma with chiasmal compression and cavernous sinus involvement, whilst getting investigated for tinnitus. His past medical history included chronic migraines only. He has been experiencing increased frequency of migraines along with lethargy, decreased libido and loss of morning erections for some time prior to presentation. His formal visual fields showed a slight inferior ...

Introduction: Calcium sensing receptor (CaSR) plays a role in calciotropic processes by regulating parathyroid hormone secretion and urinary calcium excretion. Activating mutation of the CaSR, with heterozygous gain in function, causes autosomal dominant hypocalcaemia 1 (ADH1), a rare disorder with a prevalence of 3.9 per 100,000. Aggressive treatment to normalise serum calcium causes nephrocalcinosis and hypercalcaemia. We present a case of a 27-year-old female with CaSR muta...

Introduction: Cushing’s syndrome is broadly categorized into ACTH dependent (pituitary and ectopic source) and ACTH independent (adrenal source). Localizing source of Cushing’s can sometimes be a cumbersome diagnostic process.Case history: A 25-year-old male patient presented with sudden rapid onset weight gain, muscle weakness and occasional headaches.as well as severe dyspnoea, orthopnea and PND. There was no significant past medical or famil...

Background: Ergot-derived dopamine agonist therapy (EDDAT) is associated with cardiac valvulopathy in Parkinson’s disease. The risk to patients with prolactinomas is uncertain. The EMEA/MRHA and BSE recently issued guidelines for surveillance echocardiography (ECHO) of patients receiving treatment with EDDAT. Our policy is to arrange opportunistic ECHO screening at first clinic visit guidelines.Objective: We investigated the uptake and findings of e...

We describe a 39-year-old lady who was managed as polycystic ovarian syndrome for nearly six years with an initial testosterone level of 5 nmol/l (0–1.8 nmol/l). She underwent laparoscopic ovarian drilling surgery followed by two unsuccessful IVF cycles for primary infertility. Deranged liver function and subsequent diagnosis of non-alcoholic fatty liver disease halted third trial of IVF. At that time, pelvic ultrasound demonstrated five follicles in both ovaries. In addi...

Case: A 50-years-old gentleman underwent cardiac surgery which was complicated by postoperative arrythmias and ischemic stroke. He was found to have raised calcium of 2.9 (2.2–2.6 mmol/l) subsequent to which PTH was tested and found to be raised at 34.2 (1.6–6.9 pmol/l) which increased to 41.2 pmol/l in few days. He was referred for work up and management of primary hyperparathyroidism. An USS of the neck showed 1.5 cm nodule posterior to left thyroid lobe and Sestim...

We present the case of 63 years old female patient who was diagnosed with IG G kappa multiple myeloma in 2007. Cytogenetics investigations revealed high risk for progression of the disease (cytogenetics: 17 p deletion and t (4/14). The patient decided against active treatment. Over 10 years she was kept under observation with no symptoms. Her basal paraprotein levels slowly progressed from 14 g/l up to 18 g/l. In 2017 she developed mild hypercalcaemia (corrected calcium 2.72 m...

Introduction: Lymphocytic hypophysitis is a rare inflammatory disease of the pituitary gland. The aetiology is unknown though probably of autoimmune origin. This condition usually occurs in women during pregnancy or in the post partum period. Recurrent disease in pregnancy is rare.Case report: We present a 35-year-old patient of African origin who initially presented in 2004 at 12 weeks gestation with headaches, a third nerve palsy but no visual f...

Nelson’s syndrome is a recognised complication of bilateral adrenalectomy for Cushing’s disease. The treatment of this condition can be extremely difficult. We report a case who failed to respond to traditional treatments, was given a novel chemotherapeutic agent temozolomide.A 50 years old lady was diagnosed with pituitary dependent Cushing’s disease in 1998. She underwent transphenoidal hypophysectomy (TSS) twice, followed by conventiona...

Introduction: Silent corticotroph adenomas(SCA) are defined as pituitary adenomas showing positive staining for adrenocorticotrophic hormone in immunohistochemical studies not associated with clinical/laboratory features of hypercortisolaemia. We report a case of SCA in a 61-year-old man, who presented with pituitary apoplexy.Case presentation: Patient presented with persistent diplopia of 3 months duration, associated with severe headache for 1 week. He...