Endocrine Abstracts

Hypothyroidism is common condition with a strong female preponderance and a UK prevalence of ~2%. It is normally treated with replacement oral levothyroxine.Morbid obesity is a costly public health issue with a prevalence in England of ~3% with two-thirds of sufferers being female. Weight loss surgery is increasingly employed as a successful and cost effective intervention for super-morbidly obese patients (BMI >40 kg/m2) in accordance wit...

A 46 year old male presented with abdominal pain, lethargy and intermittent fever. He described abdominal fullness with cramp-like pains in the left iliac fossa. He reported early satiety and flatulence, but denied weight loss. He had Addison’s disease, diagnosed 18 years earlier with similar symptoms at presentation and diagnostic short Synacthen test, treated with hydrocortisone 20 mg am and 10 mg pm with 100 mcg fludrocortisone once daily. He had however been increasin...

A 34-year-old lady presented with irregular periods but no galactorrhoea. A prolactin level was 1326 mU/l.Clinical examination-Normal. BMI 26 and visual fields were full to confrontation. MRI scan of pituitary was reported as large pituitary macroadenoma measuring 11× 11× 12 mm denting the optic chiasm. Results of other endocrine tests were as follows; cortisol 265 nmol/l, TSH 0.32 mU/l, FT4 8.5 pmol/l, FSH 4 U/l, LH 1.6 U/l, oestradiol 104 pmol/l, GH 8.4 mU/l, IGF1 ...

A 16-years old boy was referred for endocrine assessment of growth retardation. He had normal growth to age 7 years (tallest in his class) following which he sustained frontal head injury and subsequently exhibited growth retardation. There was no other confounding history. At age 16, height=1.47 m (below 3rd centile; mid-parental height=1.77 m), BMI=21, he was pre-pubertal. Full blood count, biochemistry and chest X-ray were unremarkable. He was 3 years behind in bone age, ha...

Symptomatic pituitary metastasis is an uncommon presentation of primary carcinoma. We report a case of a 65 years old lady who presented with a six week history of headache and diplopia and a five day history of diarrhoea and vomiting. She also suffered from osteoporosis. She had undergone a hysterectomy for a fibroid. Examination revealed diplopia in all directions of gaze, no papilloedema and an unremarkable systemic examination. Brain MRI showed a contrast enhancing pituita...

A 41 year old male presented with erectile dysfunction associated with clinical hypogonadism (testosterone 0.8 nanomoles/litre). Hypopituitarism was confirmed on endocrine testing: Free T3 2.7 picomoles/litre, TSH 1.7 milliunits/litres, LH 0.6 units/litre, FSH 2.3 units/litre, PRL 34 units/litre, GH <0.5 milliunits/litre, IGF-1 10.5 nanomoles/litre, flat response of LH and FSH to Gn-RH, GH <0.5 milliunits/litre throughout ITT. (Cortisol rose from 197 to 523 nanomoles/lit...

Unfortunate consequences may result from an incompatible combination of medical illnesses.A 17 year old girl was investigated for recurrent neutropenia, incidentally detected during a bout of tonsillitis. Coincidently she presented to us with generalised malaise, dizziness and vomiting without any other symptoms. Physical examination revealed scar pigmentation. Systemic examination was unremarkable.Biochemistry revealed hyponatraem...

Adrenal haemorrhage is comparatively rare. A 64-year-old female presented with acute right sided abdominal and chest pain shortly after a left knee replacement. She had recently started treatment dose low molecular weight heparin for presumed DVT for persistent pain in the left knee. A subsequent Doppler study of left leg was negative for DVT but an abdominal US revealed a solid lesion at the upper pole of the left kidney. CT urography showed large bilateral adrenal masses. No...

Introduction: Diseases of the hypothalamus/pituitary are complex and can be difficult to diagnose. Diagnostic possibilities are many and include sphenoid ridge meningiomas and aneurysms of the internal carotid artery as well as craniopharyngiomas, gliomas of the optic nerve, inflammatory and granulomatous disease.Case report: We present two cases to illustrate the complex differential diagnosis.The first patient presented with head...

Oestrogens act via oestrogen receptors (ER) that are expressed in a wide range of tissues including the vasculature, bone and gonads. Two ER genes known as ERalpha and ERbeta have been identified. In the human splice variants of ERbeta have been identified. ERs form both homodimers and heterodimers upon ligand binding. The aim of the present experiments was to study the functional activity of ERbeta1 (wild type) and ERbeta variant (ERbeta2) in single and double transfection as...