Endocrine Abstracts

Rare causes of severe androgen excess (AE) can present a diagnostic challenge to endocrinologists. Imaging may not identify occult ovarian pathology, and the detection of adrenal nodular disease may be indicative of incidental pathology. GnRH analogues can be used both as a medical treatment and as a diagnostic utility to confirm ovarian source, particularly in women with a preferential elevation of serum testosterone (T). In this case series, we present three cases highlighti...

Section 1: Case History: We present the case of a 52-year-old found female found collapsed at home with a three-week history of polyuria, polydipsia and lassitude on a background of primary hypothyroidism and non-insulin-dependent diabetes. On examination, she was hypothermic at 32°C, hypotensive (blood pressure 90/60 mmHg), newly oliguric, and had a Glasgow coma scale (GCS) of 9/15. A diagnosis of severe diabetic ketoacidosis (DKA) was made on admission. <p class="ab...

Primary CNS lymphoma (PCNSL) accounts for 0.85% - 2.0% of primary brain tumours. PCNSL arises in periventricular regions of the corpus callosum, with hypothalamic involvement less commonly. While cases have been reported in the literature, cranial diabetes insipidus (CDI) secondary to PCNSL is a rare phenomenon. We present this case series of three patients from our institution diagnosed with CDI and panhypopituitarism in the context of PCNSL.Cases: 1. 3...

Reproductive morbidity is increased in women with diabetes, including a higher prevalence of polycystic ovary syndrome, hypothalamic amenorrhoea and premature ovarian failure. Routine discussion of reproductive and menstrual dysfunction for women with diabetes remains a peripheral feature of clinical consultations. Here we aimed to determine women’s own reproductive care experience. We surveyed women of all ages attending routine diabetes care using a detailed clinical qu...

Ectopic ACTH syndrome is a rare condition occurring in five to ten percent of ACTH dependent hypercortisolism. We present the case of a fifty eight year old gentleman who presented with severe hyperosmolar hyperglycaemic state (blood glucose fifty seven mmol/l) and acute decompensated heart failure associated with elevated liver enzymes. Liver ultrasound followed by computed tomography of thorax abdomen and pelvis showed a lung tumour with liver metastases. Clinical suspicion ...

Lipodystrophy represents a broad spectrum of disorders, subdivided depending on aetiology (congenital or acquired) or the extent of adipose tissue absence (generalised or partial). A lack of adipose tissue results in systemic insulin resistance and ectopic fat deposition, which predisposes patients to metabolic syndrome and associated conditions such as non-alcoholic fatty liver disease and diabetes mellitus. Additionally, severe hyperinsulinaemia can generate ovarian androgen...

Ectopic adrenocorticotropic hormone (ACTH) syndrome occurs in about 5–10% of all patients with ACTH-dependent hypercortisolism. We present the case of a 35 year old gentleman who presented with a six month history of progressive 16 kg weight gain and breathlessness. Pulmonary imaging revealed bilateral infiltrates suspicious for Pneumocystis pneumonia (PCP). Physical examination was concerning for Cushing’s syndrome, with facial plethora, easy bruisability and broa...

Transsphenoidal surgery is the first-line treatment for non-functioning pituitary macroadenomas (NFPAs) causing pressure symptoms. However, the approach to asymptomatic NFPAs is unclear due to the limited data on their natural progression. This study retrospectively analysed data from patients with NFPAs who underwent conservative management for at least six months. The study screened 175 individuals treated at the National Neurosurgery/Pituitary Centre at Beaumont Hospital be...

A 51 year old presented with headaches, fatigue and generalised weakness. She had a background history of hypertension diagnosed one year prior to presentation. Initial laboratory evaluation demonstrated life-threatening hypokalaemia, potassium 0.9mmol/l(R.I. 3.5-5.3). This profound hypokalaemia required ICU admission for replacement of potassium and monitoring. Management of subsequent fluid overload necessitated a brief period of hemofiltration. During the course of evaluati...

Introduction: Polycystic ovary syndrome affects 10% of women and comes with a 2-3fold increased risk of type 2 diabetes, hypertension, and fatty liver disease. Androgen excess, a cardinal feature of PCOS, has been implicated as a major contributor to metabolic risk. Adrenal-derived 11-oxygenated androgens represent an important component of PCOS-related androgen excess and are preferentially activated in adipose tissue. We aimed to identify PCOS sub-types with distinct androge...