Endocrine Abstracts

A 55 year old man was seen in an endocrinology clinic for possible diagnosis of Cushing’s syndrome. He described a 6 months history of feeling lethargic and increased facial puffiness and abdominal fat. There Cushingoid signs on examination, namely; moon facies, thin skin and bruises with increased abdominal fat distribution. He was admitted to hospital following symptomatic hyperglycaemia and hypokalaemia (lowest reading 2.7 mmol/l). Initial laboratory results showed rai...

A 74-year-old with a history of type 2 diabetes, chronic kidney disease, vitamin D deficiency and bronchiectasis was referred to the medical team with symptomatic hypercalcaemia with raised adjusted calcium of 3.80 mmol/l. Investigations also showed raised creatinine and vitamin D levels; normal parathyroid hormone (PTH) and angiotensin-converting enzyme (ACE). Myeloma screen was negative. A diagnosis of primary hyperparathyroidism was made in view of elevated calcium and norm...

Introduction: Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a highly heterogeneous disorder and is the cause of <2% of cases of Cushing’s syndrome. Around 20-25% of patients with primary bilateral macronodular adrenal hyperplasia (PBMAH) have a mutation in ARMC5.Case report: 47 year old gentleman was incidentally found to have bilateral adrenal lesions when he had a CT scan of his chest performed for chest and back pains. He had ...

Case History: A 46 year old lady presented with deranged thyroid function (TSH 0.05, T4 19.7). She reported palpitations, mild eye irritation, sweats and weight loss. Examination revealed a resting tremor and regular pulse (72 bpm). A small goitre with bruit was present, but no evidence of thyroid eye disease. Block-and-replace regime of carbimazole and levothyroxine was commenced for Graves’ disease. Thyroid peroxidase antibodies were <1. After one year of euthyroidi...

We present the case of a woman who first presented at age 18 with hirsutism. Menarche had been normal and she had regular menses. She gave no past medical history except that at age 6 she had been admitted to hospital with tonsillitis that was complicated by diarrhoea and vomiting, drowsiness and hypotension. At that time, Na+ was 130 mmol/l and K+5.8 mmol/l. She was treated with antibiotics and fluids and improved; electrolytes returned to normal.<p ...

A 57-year-old man with a history of alcohol excess was admitted following a road traffic accident. He suffered multiple trauma with fractures to his left femur, tibia and fibula, his right pubic ramus and several ribs. In addition severe abdominal trauma necessitated nephrectomy and splenectomy. Routine biochemistry and bone profile on admission was within normal limits.He had a prolonged stay in the Intensive Therapy Unit (ITU) with acute kidney injury ...

A 22-year-old woman with hypophosphataemic rickets was diagnosed at age four when she presented with short stature and valgus deformity of the lower limbs. Biochemical testing, genetic screening and radiological investigation of her family showed no abnormality and it was concluded that she had a de novo mutation.She was treated with 1α-calcidol and phosphate Sandoz with regularly monitored biochemistry. She had poor adherence to her medicati...

Mr DP was referred by palliative care to ophthalmology with anisocoria, diplopia and nystagmus. He was known to have a poorly differentiated carcinoma of the prostate with skeletal metastasis (Gleason score 4+5=9). He was on hormonal therapy and had received radiotherapy to the cervical spine. PSA was normal, at 5.31 μg/l.An MRI scan revealed a 12 mm mass in the left side of the pituitary gland, displacing the stalk to the right and lying close to t...