Endocrine Abstracts

A 52-year-old female presented with acute left flank pain after experiencing intermittent pain, weight gain, mood disturbances and hirsutism for six months. A CT scan of the abdomen and pelvis revealed a large heterogeneous 10x7x15 cm mass in the left adrenal gland with local invasion. The patient had a past medical history of right invasive ductal carcinoma and had undergone a wide local excision. She was referred to the Endocrine team.Biochemic...

Section 1: Case history: A 39-year-old Asian lady at 18 weeks of gestation, after in vitro fertilisation pregnancy, was found to have an adjusted calcium level of 3.08 (range 2.20-2.60 mmol/l) on routine blood tests. She was asymptomatic. Her Parathyroid hormone (PTH) was 14.1 (1.1-6.9pmol/l) and 25 hydroxy vitamin D 16 (15-174 nmol/l). She had insulin treated diabetes following an episode of pancreatitis for which no cause was identified. She was treated as an inpati...

Case History: 41-year-old female presented with a 3-day history of fever, cough, and breathlessness. She had palpitations, diarrhoea and weight loss of 4-5 kg over 1 month. Graves” disease had been diagnosed 5 years prior to this episode and she had been treated with carbimazole but was not in remission. On this occasion, she was febrile and had atrial fibrillation. She also had right pleural effusion and bilateral pedal oedema.Investigations: Blood...

Section 1: Case history: We present the case of a 35-year-old gentleman referred by his GP to Endocrinology clinic for loss of libido and testosterone deficiency. His co-morbidities included obesity (BMI 59 kg/m2), hypertension and obstructive sleep apnoea (OSA) requiring overnight continuous positive airways pressure (CPAP) therapy. Routine pituitary profile showed luteinising hormone 4.8 IU/l (1–8), testosterone 7.1 nmol/l (8–25), prolactin 232 mU/l (86&...

131I-metaiodobenzylguanide (MIBG) therapy, initially introduced in the 1980s, has emerged as a first-line to treatment of malignant phaeochromocytomas. Its other notable use has been in treating neuroblastomas occurring in childhood serving as an adjuvant prior to surgery or chemotherapy. An observed known late consequence of MIBG therapy is Primary ovarian failure (POI), characterised by menstrual irregularities over a period of 4 months associated with high Follicular stimul...

Case History: A 35-year-old was referred to surgery with a confirmed diagnosis of symptomatic acromegaly. Her GH failed to suppress during an oral glucose tolerance test (OGTT), her IGF-1 and prolactin was high. The histology and immunocytochemistry suggested pituitary hyperplasia. We started to look for conditions associated with pituitary hyperplasia resulting in GHRH production, including the genetic tests for inherited conditions. A solitary nodule was noted in her neck du...

Case history: We present the case of a 70-year-old female who presented to the Emergency Department with sudden onset inter-scapular and upper abdominal pain. She had been experiencing intermittent headaches, palpitations and constipation which had not previously been investigated. The only past medical history was of hypothyroidism. She had no significant family history. There was a discrepancy in the blood pressure between both arms. Admission blood pressure was elevated at ...

Case history: We present the case of a 72-year-old lady who presented to the surgical team with sudden onset abdominal (flank) pain. On initial assessment, she was significantly hypertensive (213/110 mmHg) and tachycardic (pulse 98 bpm) but afebrile. She was not on any anticoagulation. On physical examination, her abdomen was tender with mild guarding and retroperitoneal tenderness.Investigations: Admission blood tests showed a normal haemoglobin (149 g/...