Endocrine Abstracts

Primary hyperaldosteronism (PHA), accounts for 5–10% of all hypertensive patients and is associated with increased cardiovascular risk. However, making the diagnosis is not always straightforward.A 50-year-old male was admitted with an acute myocardial infarct. He was markedly hypertensive (BP 190/100 mmHg) and hypokalemic. He was commenced on beta-blockers and an Angiotensin converting enzyme inhibitor (ACEI). Plasma aldosterone concentratio...

A 63-year-old type 2 diabetic gentleman with paranoid schizophrenia presented in October 2008 with systemic sepsis arising from multiple neuropathic foot ulcers. Foot MRI confirmed extensive osteomyelitic change. This admission followed two previous similar episodes which culminated in surgical debridement of the ulcers and amputation of the second and third toe of his left foot. Post-operatively, as his condition improved he was unable to comply with IV antibiotics, VAC dress...

Antipsychotic induced hyperprolactinaemia, mediated by blockade of dopamine D2 receptors, is much more common than prolactinoma in patients receiving antipsychotic medication. We present two cases of the latter.Case 1: A 47-year-old gentleman with depression treated with amitriptyline, fluoxetine and risperidone presented with headaches and a left sided visual field defect. Pituitary MRI showed a 2 cm macroadenoma abutting the optic chiasm. Prolactin was...

A 60-year-old gentleman who had previously undergone a right nephrectomy for renal cell carcinoma was admitted electively for a left adrenalectomy due to metastatic disease. Prior to this he had been treated with immunotherapy (Sunitinib) and radiotherapy for pulmonary and bony metastases respectively. He was given perioperative cover with hydrocortisone. A short synacthen test (SST) performed the morning after discontinuing hydrocortisone showed a baseline cortisol of 406 nmo...