Endocrine Abstracts

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&...

A 34-year old lady presented in the postpartum period following her 3rd pregnancy with severe hypertension. Her first two pregnancies were 3 and 5 years previously where she delivered via elective Caesarean section without any complications. During this pregnancy which was a twin pregnancy, her antenatal care was mainly unremarkable but on specific questioning, she reported increased sweating for a period of 4 months. Her blood pressure was noted to be normal during her antena...

Introduction: Hormone-secreting teratomas are well described. However teratomas secreting pancreatic hormones are rare, with even fewer cases producing clinically significant effects. We describe possibly the first documented case of hyperinsulinaemic hypoglycaemia due to an insulin-secreting ovarian teratoma.Case report: A 23-year-old woman presented with transient symptoms of lethargy and weakness. She had used her father’s capillary glucose meter...

A 68 year old man presented with shortness of breath and was found to have a pulmonary embolus. During work up of the underlying aetiology he was noted to have bilateral adrenal masses. He was subsequently readmitted with pyrexia and feeling generally unwell. Imaging revealed the progression of adrenal masses and there was biochemical evidence of adrenal insufficiency with a random cortisol at the low end of normal. CT guided biopsy was consistent with the diagnosis of a high ...

Case history: We present the case of a 40-year-old man who was referred to a cardiologist with hypertension. He was initiated on bisoprolol and doxazosin. Investigations revealed elevated urinary metanephrines and catecholamines, with normetadrenaline 7.4 μmol/24 h (normal <2), noradrenaline 820 nmol/24 h (normal <500) but normal dopamine levels. He was referred to our clinic. Two further 24 h urine catecholamine assays were elevated. Dexamethasone suppression tes...

The preproglucagon derived peptides glucagon, glucagon-like peptide-1 (GLP-1) and oxyntomodulin are all known to inhibit appetite and have been previously shown to activate the nucleus tractus solitarius (NTS) in the brainstem. The NTS is involved in the processing of signals transmitted from the periphery to the brain via the vagus nerve. The anorectic effects of peripherally administered glucagon and GLP-1 have been shown to be diminished or ablated by subdiaphragmatic vagot...

Case History: 17 year old boy presented with a six week history of polyuria, polydipsia, headaches and easy fatiguability. Further investigations confirmed hypopituitarism with low early morning urine osmolality. MRI brain revealed soft tissue mass arising from tectal plate extending into cerebral aqueduct resulting in hydrocephalus with normal pituitary gland. Hydrocortisone, Levothyroxine and Desmopressin were started and urgent in-patient transfer to Neurosurgical unit in t...

Clinical Case: A 48-year old male presented with gradual onset of shortness of breath and atrial tachycardia requiring admission to intensive care unit. He was normally fit and well and did not have any history of thyroid/neck surgery. He was an ex-smoker who drank more than 40 units of alcohol per week.Investigations: Laboratory tests revealed low serum calcium of 1.03 mmol/l (2.15–2.6 mmol/l), high serum phosphate of 2.77 mmol/l (0.9–1.50 mmo...

Section 1&2: Case history and investigations: Primary hyperparathyroidism is a rare condition in pregnancy. The occurrence rate is about 1 % and up to 80 % of the patients are asymptomatic. Clinical symptoms are nonspecific. However, severe maternal, foetal and neonatal complications including neonatal death have been reported in literature. 27 years old Asian lady presented to Emergency Department with abdominal pain in July 2019. She was found to have raised calcium at l...

Case history: We present a 44 year old female with persistent severe burning itchy rash over the face, scalp and upper body for ten months. She was reviewed in multiple dermatology clinics and a diagnosis of chronic urticaria was made. Despite various treatments including antihistamines and steroids, symptoms persisted affecting her quality of life significantly.Investigations and diagnosis: Routine blood investigations revealed mild persistent elevated ...