Endocrine Abstracts

A 64-year-old Sri Lankan female was admitted with a 1 week history of vomiting and poor oral intake. She had an episode of pneumonia 4 months previously and reported headaches, weight loss and dizziness since then.On admission, her blood tests showed marked hyponatraemia with a sodium of 118 mmol/l and low serum osmolality of 243 mOsm/kg. A short synacthen test confirmed adrenal insufficiency and thyroid function tests showed secondary hypothyroidism des...

The co-existence of thyrotropin (TSH) and growth hormone (GH) secreting pituitary adenoma is exceedingly rare. Less than 15 cases having been reported.Case report: A 75 years’ old man presented with new-onset atrial fibrillation. He had high FT4 with normal TSH. His ultrasound scan of the neck showed a solitary nodule. He had ablation twice and was started on bisoprolol and anticoagulant. He had an MRI scan for headaches and this showed a pituitary ...

Background: In the majority of cases, the results of TFTs are straightforward. In significant subgroup of patients, the interpretation of TFTs is more challenging, either because. The results appear discordant with the clinical picture (e.g. normal TSH in a patient with suspected thyrotoxicosis), Or measurements appear to contradict each other (e.g. raised TH concentrations, but with non-suppressed TSH).Case presentation: 29 year old Caucasian female com...

A 26 year old lady presented to her general practitioner complaining of fatigue. Investigations showed serum potassium of 2.5 mmol/l, (reference range 3.3–4.7 mmol/l). This was repeated on two more occasions and was 2.6 and 2.8 mmol/l. An ECG showed no features of hypokalaemia. She was seen in Endocrine clinic with serum potassium of 2.5 mmol/l. There was no history of an eating disorder, laxative or diuretic abuse. Her father had type 2 diabetes. Her height was 1.56 m a...

Background: Hyperinsulinaemia and insulin resistance is observed in both lean and obese women with Polycystic Ovary Syndrome (PCOS). This condition affects 52% of Asian Indian compared to 22% of Caucasian women. Lifestyle changes, particularly diet and exercise can significantly impact the future prevention of type 2 diabetes, dyslipidaemia and hypertension in these patients.Objectives: We hypothesised that regular intensive exercise would be effective i...

The majority of clinically palpable masses affecting the thyroid are benign. Malignant thyroid tumours are the commonest endocrine malignancies yet are rare. Most are of a single distinct cellular type, though mixed cellularity tumours also occur, the commonest of which is papillary and follicular. We describe 2 cases with more than one differentiated tumour in each thyroid gland.CASE 1A 44y builder with a family history of medulla...

A 27y old woman presented with a 2yr history of secondary amenorrhoea and mild hyperprolactinaemia. CT scan demonstrated an enlarged pituitary gland abutting the optic chiasm. Goldman perimetery was normal and trans-sphenoidal hypophysectomy undertaken. Post-operatively she suffered temporary diabetes insipidus responding well to desmopressin. At endocrine assessment, she was growth hormone deficient, had partial diabetes insipidus and a sub-optimal cortisol response. Desmopre...

BackgroundA fear of rising serum prolactin concentrations (PRO) and pituitary tumour enlargement undoubtedly result in over-treatment of some patients with pathological hyperprolactinaemia. In recent years, our unit has adopted pragmatic criteria for discontinuing dopamine agonist (DA) therapy in selected patients. These include: small (or no) abnormality of pituitary imaging; presentation PRO<2,000milliunits per litre; small DA dose; stable PRO; women with a history of...

A 55-year-old gentleman was referred to surgeons for screening colonoscopy in view of family history of bowel cancer. His mother, maternal aunt and two cousins had history of bowel cancer. When seen by the surgeons, he gave 4-month history of intermittent abdominal bloating and rectal bleeding. His past medical history included a recent diagnosis of hypertension, a chronic history of facial neuralgia and history of excision of numerous facial skin tags. He was on amlodipine 5 ...

A 26-year-old Caucasian female presented with nausea, intermittent abdominal pain and amenorrhoea of 3 months duration. She was known to have Von Hippel–Lindau disease (Exon 3A/T 742 mutation) and had undergone surgery for cerebellar haemangioblastoma. She also had presumed dermoid cyst in right ovary which had been monitored by ultrasound. Ultrasound revealed an increase in size and vascularity of right ovarian cyst. MRI scan revealed it to be a 6.3 cm lobulated mass in ...