Endocrine Abstracts

Case: A 77-year-old man was admitted with a pathological fracture of the right femur, which required intramedullary nailing. He had previously been diagnosed with Paget’s disease affecting the right femur and also hyperparathyroidism with a large parathyroid adenoma on Sestamibi scan which had been managed at another hospital. On this admission, his corrected calcium was 2.79 (2.15–2.55) mmol/l, PTH 643 (15–65) pg/ml and alkaline phosphatase 258 (30–130) U/...

Case 1: A 65-year-old man was admitted with symptomatic hypocalcaemia (corrected calcium of 1.65 mmol/l, PTH 46.6 (1.6–6.8) pmol/l, and vitamin D 51.4 (50–150) nmol/l)) 5 days following denosumab initiation. He had a diagnosis of probable urothelial carcinoma with associated osteoblastic metastases, and 10 days prior to this admission had been treated for hypercalcaemia (corrected calcium of 3.04 (2.20–2.60) mmol/l) with i.v. fluids following which denosumab was...

A 31-year-old woman presented with oligomenorrhoea and a raised prolactin. Pituitary scan revealed a 1.8 cm pituitary mass with compression of the optic chiasm. TSH was normal at 3.66 mIU/l with a raised FT4 of 25.8 pmol/l. The rest of pituitary function was normal. Visual fields demonstrated a bitemporal upper quadrantanopia. A diagnosis of TSH-secreting pituitary adenoma was suspected because of the high normal TSH in the presence of a high FT4. She und...

: A 61-year-old gentleman was referred to the Endocrine team with acute bilateral adrenal haemorrhage. He had undergone a successful left popliteal embolectomy for critical limb ischaemia a week ago following which he was commenced on anticoagulation therapy. He presented to the Emergency Department with acute severe abdominal pain and low grade pyrexia of 37.6 C. He was haemodynamically stable. His International Normalised Ratio was noted to be elevated at 4.7. An urgent abdo...

Introduction: Maternal hypothyroidism is associated with an increased risk of complications both to the pregnant mother and the developing fetus. The 2007 American Endocrine Society Guidelines recommend a rapid titration of thyroxine dose to attain a target TSH concentration of ≤2.5 µU/mL in the 1st trimester (≤3 µU/mL in the 2nd and 3rd trimesters). Objectives Our aims were to assess the adequacy of thyroxine replacement in pregnant women with hypothyroi...

Background: Male sexual dysfunction is common in obesity with complex underlying mechanisms. Testosterone replacement has often been initiated in clinical practice in the presence of sexual dysfunction and male obesity-associated secondary hypogonadism. The benefits to sexual functioning, however, are not well documented. The aims of the study were to investigate the relationship between sexual function and hypogonadism in severe obesity and to understand the impact of bariatr...

Background: Emerging evidence suggests that impaired high density lipoprotein (HDL) function is associated with cardiovascular disease (CVD). HDL is essential for removing excess circulating cholesterol by reverse cholesterol transport (RCT). Additionally HDL reduces inflammation and oxidative stress, especially through paraoxonase-1. Whereas HDL’s capacity to accept cholesterol from peripheral cells is key (i.e. cholesterol efflux capacity (CEC)), successful RCT depends ...

Background: Male sexual dysfunction is common in obesity with complex underlying mechanisms. Testosterone replacement has often been initiated in clinical practice in the presence of sexual dysfunction and male obesity-associated secondary hypogonadism. The benefits to sexual functioning, however, are not well documented. The aims of the study were to investigate the relationship between sexual function and hypogonadism in severe obesity and to understand the impact of bariatr...

Background: Emerging evidence suggests that impaired high density lipoprotein (HDL) function is associated with cardiovascular disease (CVD). HDL is essential for removing excess circulating cholesterol by reverse cholesterol transport (RCT). Additionally HDL reduces inflammation and oxidative stress, especially through paraoxonase-1. Whereas HDL’s capacity to accept cholesterol from peripheral cells is key (i.e. cholesterol efflux capacity (CEC)), successful RCT depends ...

Introduction: Pituitary metastases (PM) are an uncommon manifestation of Neuroendocrine neoplasms (NENs) and are rarely reported. We report two cases of PM with different clinical lessons.Case 1: A 37-year-old female underwent surgical resection for a high grade poorly differentiated neuroendocrine carcinoma of the cervix (Ki67 90%). Serial follow-up surveillance assessments revealed disease progression (local, liver, lung, and bone) for which she underw...