Endocrine Abstracts

A 37-year-old man presented with persistent right hip pain and night sweats. CT of chest, abdomen, and pelvis revealed a right iliopsoas abscess from which mycobacterium species tuberculosis isolated. He commenced quadruple agent anti tuberculous chemotherapy. Repeat CT 1 year later showed complete resolution of the abscess but a 3.3×1.7 cm mass replacing the right adrenal gland. Considered likely to represent healed tuberculous lesion, treatment completed, and patient di...

A 55-year-old female presented to her General Practitioner with hirsutism, male pattern baldness, weight gain and a deepening of voice. Her past medical history included well controlled type 2 diabetes on gliclazide, and hysterectomy for menorrhagia. She had an elevated serum testosterone after solvent extraction (18 nmol/l) and free androgen index (17.6). The patient was referred for further investigation.17-Hydroxyprogesterone and dehydroepiandrosteron...

Background/aims: The short synacthen test (SST) is a dynamic function test used to assess the hypothalamic pituitary adrenal axis. Interpretation requires consideration of sample timing and cortisol method. Currently the 30 minutes post-synacthen cortisol (CORT30) at NHS Greater Glasgow and Clyde (NHS GGC) is >450 nmol/l measured on the Abbott Architect. A large reference range study published a cut-off of >430 nmol/l for this method. This audit aims to document clinic...

We present a diagnostically challenging case of a 22-year old female with short stature and recurrent admissions with severe hypokalaemia, hypocalcaemia and hypomagnesaemia since infancy.Case: Our patient was born at 38 weeks gestation following a pregnancy complicated by intrauterine growth restriction since 28 weeks. She had low birthweight of 2.4 kg and significantly shorter length and lower head circumference than expected. Mild dysmorphic features o...

We present a diagnostically challenging case of a 22-year old female with short stature and recurrent admissions with severe hypokalaemia, hypocalcaemia and hypomagnesaemia since infancy.Case: Our patient was born at 38 weeks gestation following a pregnancy complicated by intrauterine growth restriction since 28 weeks. She had low birthweight of 2.4 kg and significantly shorter length and lower head circumference than expected. Mild dysmorphic features o...

Bilateral inferior petrosal sinus sampling (BIPSS) is the gold standard investigation in Cushing’s disease for identifying the pituitary as the ACTH source. This technique aims to demonstrate a gradient of central:peripheral ACTH levels of >2:1 in such patients, or >3:1 after CRH stimulation. In patients without significant pituitary MRI abnormalities this facilitates neurosurgical exploration.The test is limited by difficulties in achieving...

Phaeochromocytomas (PHAEOs) and extra-adrenal paragangliomas (PGLs) are rare neuroendocrine tumours. As many as 35% may have an identifiable germline mutation, most commonly in the genes encoding RET, VHL or subunits of succinate dehydrogenase (SDHx).[123I]-labelled metaiodobenzylguanidine (123I-MIBG) scintigraphy is used to localise PHAEOs/PGLs, while 131I-MIBG is used as therapy in malignant disease. Uptake of radioisot...

Background: GH therapy in adolescents with childhood onset GH deficiency (CO-GHD) is often necessary to prevent adult GHD syndrome. This requires re-evaluation of the GH axis on attainment of final height.Aim: Retrospective review of outcome in young adults diagnosed with CO-GHD Design: Clinical details were collected on young adults with CO-GHD patients between 2005 and 2011 at one tertiary centre. Result: 62 former CO-GHD patients, 40 male: 22 female, ...

A 60 year old female from Zimbabwe with an eight year history of HIV infection presented with malaise and facial swelling. She had been established on antiretroviral treatment (Kivexa (lamivudine / abacavir) and Kaletra (lopinivir / ritonavir)) since shortly after her initial diagnosis. One month earlier she had received an injection of intramuscular triamcinolone acetate to treat an inflammatory polyarthropathy. She was also prescribed inhaled salmeterol xinafoate 50 mcg/flut...

A 54-year old female presented with fluctuating consciousness and seizures 4-weeks after gastric sleeve surgery. On admission blood glucose was 1.1 mmol/l, GCS was 10 and she was tachycardic. Examination was otherwise unremarkable. Her GCS improved after Glucagon and Glucogel. She described episodes of disorientation, slurred speech, fatigue and dysthesia since her surgery. These occurred particularly in the morning and her symptoms impro...