Endocrine Abstracts

A 20-year-old girl presented to the endocrine clinic with a history of three stone weight gain, and development of numerous purple striae over her lower abdomen, inner thighs and upper arms, gradually progressing over a 12-month period. The onset of symptoms had coincided with the initiation of contraceptive depot medroxyprogesterone acetate, which was discontinued two months prior to her presentation. Her 9 am cortisol was <50 nmol/l.She had a backg...

There are limited morbidity data regarding patients with adrenal insufficiency. We undertook a retrospective study to examine the aetiology and frequency of emergency hospital admissions. We identified 69 patients receiving hydrocortisone replacement for adrenal insufficiency. 50 medical records were obtained; 20 patients had primary adrenal failure (including CAH) and 30 patients had ACTH deficiency. All emergency admissions that occurred within the last 10 years were reviewe...

A 19 year old girl presented at 39 weeks gestation with headache and blurring of vision. MRI showed an enhancing pituitary mass measuring 1.2 cm maximum height, extending suprasellarly and distorting the optic chiasm. Visual field testing showed bilateral constriction. 0900 h cortisol was 502 nmol/l, thought to be relatively low for the stage of pregnancy and FT4 was 9.3 pmol/l suggesting TSH deficiency. Prolactin was appropriately raised for the gestational age at 4951 mU/l.<...

A 25-year-old Asian man presented with a 6 month history of erectile dysfunction, loss of libido and reduced exercise tolerance. His past medical history included ulcerative colitis, treated with long-term prednisolone and mesalazine for 8 years. He weighed 116 kg and his BP was 144/86 mmHg. He had bilateral gynaecomastia but no galactorrhea. Testicular volumes were 8 ml bilaterally and secondary sexual characteristics were normal. He was clinically euthyroid.<p class="abs...

Ectopic ACTH secretion accounts for 11–25% of Cushing’s syndrome, most commonly resulting from small cell lung carcinoma and bronchial carcinoid tumours. Ectopic ACTH requires meticulous consideration in the differential of ACTH-dependent Cushing’s syndrome. Thymic carcinoids are a very rare cause of ectopic ACTH secretion, accounting for 5–12% of cases. A 28 year old gentleman was diagnosed with Cushing’s syndrome after presenting with lethargy, hyper...

Insulinomas are rare neuroendocrine tumours with an estimated incidence of up to four new cases per mill./p.a. Most tumours are benign, <2 cm and arise from the islets of Langerhans.Typically patients present with Whipple’s triad: symptoms of hypoglycaemia, caused by fasting or exercise, low plasma glucose and symptoms relieved by Food. The diagnosis is confirmed by high insulin and c-peptide levels, inappropriately high for prevailing glucose.<...