Endocrine Abstracts

Section 1: Case history: A 17 year old lady who was referred to our endocrinology clinic due to primary amenorrhoea in 2019. She had well-established secondary sexual characteristics and hyperprolactinaemia. Patient mentioned one episode of PV bleed when she was about 10 years old. Section 2: Investigations: Bloods (Feb2020) showed: FSH: 6.2 IU/l; LH: 5.1IU/l; prolactin 1.048 mIU/l; testosterone 1.3 nmol/l. MRI pituitary: lipoma of corpus calosum and pit...

Case history: This 28 year old lady with a new diagnosis of T1DM (April 22) and uveitis complained of severe pain over the trunk described as a burning sensation but not associated with any neurological deficit. There is no history of head trauma, neck trauma or radiation to head and neck area and no skin changes or spinal deformity. She has developed this pain after starting insulin in April 22. Investigations: May 22: Hb 119, MCV: 85.0; U&Es:normal...

We present the case of a 32-year-old gentleman who was reviewed in the endocrinology clinic for hypogonadotropic hypogonadism and he was investigated for persistent HTN. His only symptoms were anxiety and palpitations. We have controlled his blood pressure with doxazosin 10 mg BD and bisoprolol 1.25 mg OD. Investigations: bloods (Jan 23) normetanephrine:3,460 picomole/l, metanephrine:120 picomole/l, aldo/renin ratio: 92, TSH 2.3, prolactin 307, IGF-1: 26,6, testosterone: 5,9 n...

Introduction: Hyponatraemia is defined as serum sodium concentration <135 mmol/l. It is the most common electrolyte disorder encountered in clinical practise. It is associated with an increase in mortality and length of stay, independent of diagnosis and clinical variables. Despite this it is often inadequately investigated and poorly managed. As a number of endocrine conditions can cause hyponatraemia, endocrinologists often have the necessary clinical skills and expertis...

Introduction: Hyponatraemia is defined as serum sodium concentration <135 mmol/l. It is the most common electrolyte disorder encountered in clinical practise (1). Proton pump inhibitors (PPI’s) are commonly prescribed in the UK, and the indication and duration of treatment is often not reviewed.Methods: A retrospective audit was performed of patients admitted to The Great Western Hospital (GWH) with a serum sodium of 127 mmol/l or less on admiss...

Introduction: Hyponatraemia is defined as serum sodium concentration <135 mmol/l. It is the most common electrolyte disorder encountered in clinical practise. It is associated with an increase in mortality and length of stay, independent of diagnosis and clinical variables. Despite this it is often inadequately investigated and poorly managed.Methods: A retrospective audit was performed of patients admitted to The Great Western Hospital (GWH) serum s...

Introduction: Hyponatraemia is common and associated with significant morbidity and mortality. However, it’s often not recognised as a serious diagnosis and therefore inadequately investigated and poorly managed. An audit of the management of patients admitted to The Great Western Hospital (GWH) with hyponatraemia confirmed these problems. A hyponatraemia guideline was produced in order to improve diagnosis, investigation, and management of patients with hyponatraemia.</p...

Fasting blood glucose is key to diagnosing diabetes, whilst the Oral Glucose Tolerance Test (OGTT) is a valuable adjunct when diagnosis is borderline or inconclusive. The OGTT is often used to detect early changes in glucose tolerance and predict a likely path to overt Diabetes Mellitus for example in gestational diabetes.A 42 year old female, referred to the Endocrine services for episodes of symptomatic hypoglycaemia. Past medical history included pylo...

Background: Hyperprolactinemia is one of the most common endocrine disorders of the hypothalamic-pituitary axis. It is difficult to differentiate between stress induced hyperprolactinemia and true hyperprolactinaemia and may result in patients having unnecessary imaging.Methods: We have collected data for 46 patients who had a cannulated prolactin test between January 2017 and June 2023 in the Royal United Hospital of Ba...

A 44-year-old man referred with erectile dysfunction was found to have hypogonadotrophic hypogonadism (HH), but otherwise apparently normal anterior pituitary function (LH 1.6 & FSH 2.7 IU/l; T 3.4 & cortisol 516 nmol/l; PRL 103, GH 5.5 & TSH 2.8 mU/l; f-T4 13, f-T3 4.8 & f-T 128 pmol/l; ferritin 103 ug/l). He appeared normally virilised, with central obesity (BMI 36 kg.m−2, collar size 46 cm) and symptomatic sleep apnoea (SA). MRI showed a rig...