Endocrine Abstracts

A 30-year-old female presented to accident and emergency having been found collapsed. The patient had a reduced Glasgow Coma Scale of 10, was pyrexial, clinically in shock and pale in colour. Initial investigations confirmed hypoglycemia and a metabolic acidosis. A collateral history described a 3 days history of diarrhoea. Her 5-year-old child (who was conceived normally) also had diarrhoea.The impression was of shock secondary to sepsis and hypovolemia...

Introduction: Current guidelines from The Endocrine Society indicate that 2 different tests from urinary free cortisol (UFC) measurement, salivary cortisol (SC) measurement, low-dose dexamethasone suppression test (LDDST) or overnight dexamethasone suppression test (ODST) are required to diagnose Cushing’s syndrome (CS). The low-dose dexamethasone test (LDDST) is often used as the confirmatory test when diagnosing CS. The overnight d...

Introduction: Current guidelines from The Endocrine Society indicate that 2 different tests from urinary free cortisol (UFC) measurement, salivary cortisol (SC) measurement, low-dose dexamethasone suppression test (LDDST) or overnight dexamethasone suppression test (ODST) are required to diagnose Cushing’s syndrome (CS). The low-dose dexamethasone test (LDDST) is often used as the confirmatory test when diagnosing CS. The overnight d...

Introduction: Misdiagnosis of secondary hypocortisolaemia can have profound consequences on a patient’s life. Due to contraindications the gold standard dynamic diagnostic test of cortisol reserve – the insulin tolerance test (ITT) – may not always be suitable. Here we examine the diagnostic accuracy of the second line dynamic tests: the overnight metyrapone test (OMT), short synacthen test (SST) and glucagon stimulation test (GST).Patient...

Background: Hyperprolactinaemia is common in patients presenting with polycystic ovary syndrome (PCOS). Recent studies suggest that each condition has an independent aetiology, hence appropriate investigation of hyperprolactinaemia in the context of PCOS is required, for which separate treatment may then be provided. Appropriate investigation includes a serum macroprolactin screen, a specific drug history for drug-induced hyperprolactinaemia (DIH), blood tests to exclude secon...

Objective: To highlight the issue of vitamin D supplementation in patients with sarcoidosis.Case report: We report the case of a 66-year-old lady, who presented with one week history of general weakness, drowsiness, nausea and confusion. 6-weeks prior to presentation, she underwent right-sided intra-medullary nail insertion for a traumatic femur fracture, whilst abroad. Her past medical history includes stage IV pulmonary sarcoidosis, pulmonary hypertens...

A 48-year-old lady presented to neurology with a 2 year history of progressive leg weakness, rendering her wheelchair-bound. Neurological examination revealed a proximal myopathy. She had a 2 year history of diabetes, and an endocrine opinion was sought to see if the clinical features could be related to diabetes. It was then noted that she appeared Cushingoid, with a blood pressure of 158/92, central obesity, striae and facial acne. She had been amenorrhoeic for 2 years. Endo...

Adrenal lesions are commonly detected incidentally during cross-sectional imaging examinations, and the majority are benign adrenal adenomas. A 52 year old gentleman with a history of hypertension and paroxysmal atrial fibrillation was referred to our service following a fall in which he fractured several ribs. Subsequent abdominal CT revealed an incidental finding of bilateral adrenal masses, reported as approximately 5 cm and 4 cm on the right and left side respectively with...

A 58 year old female, with a 15 year history of hypertension and recent poor control, was admitted to the emergency department after an out of hospital cardiac arrest due to ventricular fibrillation requiring DC cardioversion. Initial investigations showed a metabolic alkalosis with profound hypokalaemia at 1.7 mmol/l. In view of lateral ST depression on the ECG post-resuscitation, she underwent an urgent coronary angiogram which demonstrated unobstructed coronary arteries. Wh...

Case: A 46-year-old woman was initially investigated for right sided intermittent headaches for one year. Her MRI head revealed a pituitary adenoma. She had no history of vomiting with the headache episodes and had no history of visual acuity or field defect. She had amenorrhoea for the past 10 months. Prior to this, she had regular periods following her menarche at the age of 12 years. She admitted to easy bruising but had no hirsutism or acne. She did not report any weight g...