Endocrine Abstracts

Introduction: We present a case which highlights the non-specific nature of the presenting symptoms of adrenal failure due to bilateral adrenal haemorrhage.Case report: A 75-year-old gentleman had an uncomplicated right total hip replacement for osteoarthritis and his warfarin for atrial fibrillation was restarted on the third post-operative day before discharge. A week later, he was admitted with watery diarrhoea and vomiting. On examination, he was cli...

Directly Observed Therapy (DOT) is the World Health Organization standard used for tuberculosis treatment, where a trained health worker watches the patient swallow every dose. It can be used for patients receiving doses of Levothyroxine of more than 2 μg/kg with persistently increased TSH levels as they are considered to have thyroid deficiency refractory to treatment. Poor adherence is the most common cause of failure of therapy and if this is suspected, a supervised te...

Introduction: We present a case of a gentleman with non-islet cell tumor hypoglycemia (NICTH), a rare cause of spontaneous hypoglycemia that presents clinical challenges in maintaining euglycaemia.Case report: A 76-year-old gentleman not known to be diabetic presented with confusion and agitation. On admission he had a blood glucose reading of 2.1 mmol/l and clinical examination confirmed an abdominal mass. He was initially resuscitated with i.v. dextros...

Introduction: Polycystic ovarian syndrome (PCOS) is a common cause of hyperandrogenism in women of reproductive age but rarely causes very high testosterone levels and frank virilisation which is associated with ovarian or adrenal tumours. We present a rare case of progressively increasing testosterone levels causing virilisation from a histologically confirmed right polycystic ovary. Complete cure was achieved by right salpingo-oophrectomy.Case: A 32 ye...

A 26 year old lady under investigation for infertility was referred to our endocrine clinic for raised testosterone levels at 6.6 nmol/l (0.5–2.8).she had regular period with no features of hirsutism. Her past medical history included common acute lymphoblastic leukaemia on chemotherapy, liver cirrhosis with portal hypertension secondary to chemotherapy, Trans jugular intrahepatic portosystemic shunt (TIPS) insertion for bleeding gastric varices.Cli...

A 37 year old lady with relapsing Graves’ thyrotoxicosis initially managed on a ‘block and replace regime’ with propylthiouracil and levothyroxine for 7 years had her medication changed to carbimazole after a relapse from non-compliance but developed agranulocytosis. She was then restarted on an increased dose of propylthiouracil alone. Two weeks later, she developed tender purpuric lesions and was admitted after developing painful bullous lesions to her lower l...