Endocrine Abstracts

We report a 42-year-old female who was known to have autoimmune hypothyroidism for nearly 20 years with positive antiTPO antibodies. She was well controlled on levothyroxine including three antenatal periods when she required a slightly higher dose of 125 mcg daily. No significant past medical history and denies use of herbal/over the counter medications. In early 2017, the patient started to experience nonspecific symptoms of lethargy and tiredness. Her thyroid state was mana...

Pregnancy and lactation-associated osteoporosis (PAO) is a rare syndrome of spontaneous fragility fractures, most commonly vertebral, occurring in late pregnancy or lactation. The aetiology and pathogenesis of this osteoporosis are unknown, and early diagnosis and management are essential because of the severity of the morbidity associated with these fractures. The management includes cessation of breastfeeding, use of specific osteoporosis drugs, and adequate analgesia.<p...

Introduction: Iatrogenic Cushing’s syndrome from potent topical steroid use, resulting in suppression of the hypothalamic-pituitary-adrenal axis is well recognised. However, this may not be well acknowledged in amongst a general medical take. We report a case of Cushing’s syndrome from long term use of skin whitening cream and topical steroids, highlighting the importance of detailed history taking.Case history: A 49-year-old Nigerian female wa...

Background: The ACTH receptor (melanocortin 2 receptor – MC2R) is unique in that it is highly selective for ACTH and excludes all other MSH peptides. This contrasts with all other members of the melanocortin receptor family, which show broader specificity. The specificity of recognition of ACTH by the MC2R appears to depend on the presence of four basic residues, lysine, lysine, arginine, arginine at positions 15–18. Of α-, β- and γ-MSH are either iden...

Introduction: Endogenous cortisol secretion should cease after bilateral adrenalectomy (BAL) and steroid hormone replacement is life sustaining at the regular physiologic dosage. However, there are reports of occurrence of functioning adrenal tissue in the setting of BAL treatment for ACTH dependent Cushing’s syndrome and not the other known indications for BAL.Case report: A 44-year-old lady with functioning adrena...

Background: Generalized glucocorticoid-resistance (GCR) is a broad spectrum and heterogeneous syndrome that may be familial or sporadic caused by mutations in glucocorticoid receptor function and signalling. These patients present with hypercortisolism with enlarged adrenals but no Cushing features. Identification of GCR requires extensive investigations.Case report: An 81-year-old thin-built man of South-East Asian orig...

Background and aims: Atherosclerosis is more prevalent among people with chronic kidney disease (CKD) than among those with normal renal function. Ankle-brachial index (ABI) and toe-brachial index (TBI) are a simple useful method for assessing peripheral atherosclerosis. The aim of our study was to investigate whether ABI or TBI were more strongly associated with progression of diabetic nephropathy such as change of urinary albumin/creatinine ratio (ACR), serum creatinine leve...

Introduction: Primary aldosteronism (PA) is the most common cause of secondary hypertension that can be cured by surgery. Mild autonomous cortisol co-secretion is a recognised feature of PA, which is associated with an increased cardiometabolic penalty and the possibility of adrenal insufficiency postoperatively. There have also been case reports of adrenal crisis post adrenalectomy for this patient subtype. We report our experience of adrenal insufficiency post adrenalectomy ...

Case history: 63 year man with two trans-temporal incomplete resections of a glomus jugulare tumour (HNPGL) in 1993 and 2000 with regular surveillance scans for residual disease. Eight years later, an MRI demonstrated an incidental pituitary macroadenoma with cavernous and sphenoid sinuses invasion. The patient was asymptomatic but, his biochemistry revealed a markedly raised prolactin of 43,000 mIU/l with no other pituitary hormone deficiency. Cabergoline was commenced and th...

In recent years, there is increased interest in using maggot debridement therapy (MDT) for ulcer treatment. MDT has shown beneficial effects on ulcers’ rate of healing, need for surgical intervention, and number of antibiotic-free days. In this retrospective study, we looked into the effects of MDT on the length of inpatient stay and need for surgical intervention.Data were collected from 33 randomly selected patients admitted into hospital with pri...