Endocrine Abstracts

Cushing’s syndrome and obesity share clinical similarities. Here we present a 31-year-old lady with type 2 diabetes, renal failure, polycystic ovarian syndrome, depression, hirsutism and morbid obesity, whose abnormal phenotype and biochemistry normalised with weight loss.She was admitted with a history of recent onset recurrent hypoglycaemia and poor mobility. A detailed history revealed increase in weight over a 10 year period associated with irre...

Introduction: Testosterone replacement therapy is the standard treatment for hypogonadism. However, there are also serious side effects which clinicians should be aware of. Here we present a case of unusual side effect related to testosterone therapy.Case history: A 90 year-old gentleman attended A&E with gradually worsening confusion and dyspnoea. His breathing had deteriorated in the last week with marked decrease in exercise tolerance. Investigati...

Introduction: The reason for weight gain is multifactorial. Effective intervention can only be incorporated if the underlying cause is evaluated correctly. Here we present a lady with Addison’s disease who gain significant weight and was helped to lose weight using a novel approach.Case-Report: 42 year-old lady was referred to our weight-management service as she was unsuccessful in losing weight. Detailed evaluation in the obesity clinic revealed t...

Introduction: Prevalence of obesity is increasing worldwide. As a consequence the number of people undergoing bariatric surgery is also on the rise. Hypoglycaemia is increasingly seen in patients who have undergone gastric bypass surgery and we have successfully managed most of them. Here we describe our experience in dealing with one of the patients with disabling hypoglycaemia.Case-report: A 35-year-old woman with BMI of 41.87 kg/m2 had Roux...

Introduction: Bariatric surgery is now a common surgical procedure for weight management recommended by NICE. Complications such as dumping syndrome, micronutrient deficiencies are well documented in the literature. Here we discuss a lesser reported complication of adrenal insufficiency and its management in five patients following gastric bypass surgery.Case reports: All patients presented with one or more of the following symptoms: sweating, anxiety, w...

Introduction: Idiopathic Pituitary atrophy is rare cause of pan hypopituitarism. Various hypotheses were proposed to identify aetiology of idiopathic pituitary atrophy. Still definite cause is not known. There are very few reported cases of pituitary atrophy. We present a case of pituitary atrophy that required complete replacement of pan hypopituirsm to alleviate her symptoms.Case report: About 64 year lady was referred for evaluation of hyponatraemia a...

Introduction: Insulinoma is a neuroendocrine tumour derived from the pancreatic islet cells producing excessive amounts of insulin. It can be seen at every age but mostly seen in females above age 50 years old. Because of nonspecific symptoms 20% of cases are misdiagnosed primarily. Major symptoms and signs are related to hypoglycaemia and become significant due to exercise and fasting. This case reveals the diagnostic difficulty due to hypoglycaemia unawareness.<p class="...

Introduction: Cushing’s syndrome (CS) is a rare disease that can be difficult to diagnose. 24 hour urinary free cortisol (UFC) is one of the reliable screening tests to diagnose CS. The Endocrine Society recommends against widespread screening for CS. It advises to screen those patients presenting with multiple and progressive features (easy bruising, facial plethora, proximal myopathy and striae) of CS, in addition to patients who experience unusual features for their ag...

Introduction: Bariatric surgery is now a common surgical procedure for weight management recommended by NICE. Complications such as dumping syndrome, micronutrient deficiencies and cholelithiasis are well documented in the literature. Here we discuss the lesser reported complication of adrenal insufficiency seen in three patients following roux-en-y gastric bypass surgery for morbid obesity.Case reports: Three patients were seen in the outpatient clinic ...

Introduction: Obesity is known to be associated with hypogonadotropic hypogonadism. Hypogonadism is an established risk factor for cardio vascular disease and Type 2 Diabetes Mellitus (T2DM). However there is paucity on the evidence on improvement in testosterone with bariatric surgery. We report two patients with normalisation of testosterone after bariatric surgery.Case Reports: Patient One 69 year old with BMI 40 and T2DM, hypertension, ischaemic hear...