Endocrine Abstracts

A 79-year-old man presented with a fall and vomiting. The finding of significant postural hypotension associated with severe hypotonic hyponatraemia (Na 114 mmol/L, Osmolarity 244 mmol/L) mandated a Short Synacthen Test (cortisol 98 mmol/L at baseline and 238 mmol/L 30-minute post synacthen) and ACTH (6 ng/L) which confirmed central hypoadrenalism. This led to revelation of multiple pituitary axes involvement: hypogonadism (testosterone 1...

A 79-year-old man presented with a fall and vomiting. The finding of significant postural hypotension associated with severe hypotonic hyponatraemia (Na 114 mmol/L, Osmolarity 244 mmol/L) mandated a Short Synacthen Test (cortisol 98 mmol/L at baseline and 238 mmol/L 30-minute post synacthen) and ACTH (6 ng/L) which confirmed central hypoadrenalism. This led to revelation of multiple pituitary axes involvement: hypogonadism (testosterone 1...

A 60 year old Caucasian woman was referred to endocrine clinic with persistent hypercalcaemia between 2.8 and 2.9 mmol/l (2.2–2.6), with inappropriately normal PTH at 7 pmol/l (1.48–7.63). Her hypercalcaemia was noted first in 2008. She had no signs or symptoms associated with hypercalcemia. However, she has a strong family history of hypercalcaemia, where her mother required Cinacalcet to control her hypercalcaemia despite two previous parathyroid resections. She ha...

Case: A 79 years old frail lady with history of dementia and hypertension presented with refractory hypoglycaemia over a period of 3 months requiring multiple admissions. During her most recent admission, she required continuous dextrose infusion to maintain euglycaemia. The severe spontaneous hypoglycaemia in this non-diabetic lady, warranted a series of investigations. TFT and Short Synacthen Test excluded thyroid dysfunction and hypoad...

Case: A 79 years old frail lady with history of dementia and hypertension presented with refractory hypoglycaemia over a period of 3 months requiring multiple admissions. During her most recent admission, she required continuous dextrose infusion to maintain euglycaemia. The severe spontaneous hypoglycaemia in this non-diabetic lady, warranted a series of investigations. TFT and Short Synacthen Test excluded thyroid dysfunction and hypoad...

Management of type-2 diabetes (T2D) should be individualised given recent increase in treatment options. There is a spectrum of phenotype of T2D from thinner patients who may be more insulin deficient to those who are overweight/obese and insulin resistant. We hypothesized that, if we are personalising treatment, thinner patients would be more likely to be treated with insulin secretagogues. To compare the management between these phenotypes, we reviewed 1007 patients with T2D...

A 48 years old lady with BMI of 46kg/m2 was postmenopausal since age 45. Due to abdominal discomfort she had an abdominal CT, which incidentally identified bilateral adrenal adenoma (9 mm on right, 18 mm on left, with fat content). This resulted in Endocrinology referral and a history of gradually worsening hirsuitism was uncovered. Her hyperandrogenism was confirmed biochemically with markedly elevated testosterone at 6.5 nmol/l (0.0–1.8), leading to a search ...

Section 1: Case history: A 38 year old female was identified as carrying a heterozygous pathogenic MEN1 variant (c.13404delG) through predictive testing, following a diagnosis of familial hyperparathyroidism.Section 2: Investigations: Routine screening for hyperparathyroidism and pituitary disease was negative. However, a CT thorax–abdomen–pelvis revealed a 41 mm pancreatic tail mass. Biopsy via endoscopic ultrasound confirmed a well-d...

A 38 year old female was identified as carrying a heterozygous pathogenic MEN1 variant (c.13404delG) through predictive testing, following a diagnosis of familial hyperparathyroidism. Routine screening for hyperparathyroidism and pituitary disease was negative. However, a CT thorax-abdomen-pelvis revealed a 41 mm pancreatic tail mass. Biopsy via endoscopic ultrasound confirmed a well-differentiated (grade 1) pancreatic neuroendocrine tumour (pNET) with MIB1<1%. Bi...