Endocrine Abstracts

Introduction: Paragangliomas (PGLs) are extra-adrenal, neural crest-derived neuroendocrine tumours. There are sympathetic (usually abdominal and thoracic regions) or parasympathetic PGLs (head and neck). Catecholamine excess usually occurs in sympathetic PGLs.Case: A 34-year-old lady initially presented with left-sided neck swelling. She was diagnosed with left cervical PGL which was excised. Twenty years later, she noticed another lump in the same regio...

Background: The incidence of type 1 diabetes mellitus is increasing worldwide with recent European data suggesting annual increases ranging from 0.6 to 9.3%, the overall rate being 3.9%. It was thought that the Republic of Ireland (ROI) had one of the lowest disease incidences in Europe. The first Irish study of T1DM incidence which provided a measure of case ascertainment, confirmed a high incidence rate (IR) at 16.6 per 100 000 placing this population, in the upper quartile ...

Thyroid eye disease (TED) is clinically evident in 25–50% of patients with Graves’ disease and 3–5% of cases develop severe eye disease. We present a case of very aggressive TED.A 46-year-old gentleman developed graves thyrotoxicosis and was blocked and replaced with carbimazole and thyroxine. He continued to smoke 20 cigarettes/day despite several advises.He developed marked exophthalmos (L>R), chemosis, with re...

Background: Metyrapone is commonly used in medical management of Cushing’s syndrome. It inhibits 11-β hydroxylase, which catalyses the conversion of 11-deoxycortisol to cortisol. The adequacy of metyrapone blockade can be assessed either clinically or biochemically using a target mean serum cortisol 150–300 nmol/l. Cortisol is normally measured by immunoassay.Case report: A 21-year-old female presented with clinical and biochemical feature...

Background: Metyrapone inhibits 11-β hydroxylase and causes a subsequent rise in the cortisol precursor, 11-deoxycortisol. Cortisol measurements by immunoassays are susceptible to interference and reagent antibody cross-reactivity with cortisol precursors when used in patients receiving metyrapone treatment. Clinicians rely on clinical and biochemical features of cortisol excess for dose titration of this medical blockade. The extent of this interference remains unclear. ...

Our nurse-led testosterone replacement clinic in the Waikato Endocrine Service was the only clinic in New Zealand where specialised endocrine nurses established the use of and administered subcutaneous implants using testosterone pellets for hypogonadal men. Information gained through networking with nursing colleagues at the Annual Endocrine Nurses Society of Australasia (ENSA) symposia regarding the introduction of the depot injection Testosterone Undecanoate (Reandron™...

Introduction: α-Defensins are recently described peptides, which are part of the innate immune system. Increased circulating levels are observed in conditions associated with chronic low grade inflammation, such as ischemic heart disease and in diabetes mellitus (DM). Recently we reported adverse prognostic implications of high α-defensins in patients with type 1 DM. However, it is not clear whether this finding may be generalized to include other groups such as pati...

Case report: A 52-year-old woman presented with an 11-month history of increasing hirsutism and deepening voice. She had a past history of total abdominal hysterectomy (ovaries preserved) with adjuvant chemotherapy and radiotherapy for cervical carcinoma. She was on no medication. Examination revealed evidence of virilisation with no other abnormality.Investigations: Total testosterone=10.7 nmol/l (<2.9).FSH=31.7 U/l (37–1...

Gitelman’s syndrome (GS) is a rare autosomal recessive renal tubular disorder caused by defects of thiazide sensitive Na-Cl co-transporter due to mutations of the SLC12A3 gene.We report a case of a 23-year-old woman, who presented with excessive tiredness in her second pregnancy. She had a past history of hypokalaemia in a previous pregnancy (attributed to ‘vomiting’), which required multiple admissions for i.v. potassium replacement despi...

Background: Hypothyroidism is reported to be associated with mild insulin resistance though severe insulin resistance is rare. We report the case of a man presented with reversible severe insulin resistance in hypothyroidism.Case report: A 23-year-old obese man with autism was presented with poor responsiveness (GCS 7/15). He had general malaise for 2 days prior to admission. On admission, his test results showed random glucose – 60.8 mmol/l, potass...