Endocrine Abstracts

Case ReportA 36 year old Asian female presented to the Accident and Emergency with a sudden collapse.On examination, the patient was pyrexial at 38.3 degC and had a Glasgow Coma Scale of 4 associated with nuchal rigidity. The patient was ventilated and transferred to ITU. An MRI head scan revealed a large ring enhancing lesion in the hypothalamus which extended to the third ventricle. There was also diffuse lepto-meningeal enhancement with hydrocephalus....

Objective: The terminology used to describe abnormalities of sex determination and sex differentiation was revised in 2006. It was anticipated that new terms, such as “disorder of sex development” (DSD), would improve communication between health professionals, aid parental understanding and be acceptable to affected individuals. The purpose of this study was to evaluate whether the new terminology has been an improvement compared to previous nomenclature.<p clas...

Backround: Recent research has heightened the controversy surrounding the effects of conventional hormone replacement therapy on cardiovascular risk, suggesting that use of HRT is associated with an increase in cardiovascular morbidity and mortality. Testosterone has also been associated with unfavourable cardiovascular parameters and the addition of testosterone to HRT may augment the risk of cardiovascular events in postmenopausal women.Aim: To elucida...

We present two patients with unusual manifestations of sarcoidosis and review gonadal involvement in this rare but important disease. A 27 year old man presented to the Ophthalmologists at our hospital with a red eye. He was diagnosed with anterior uveitis and commenced on topical corticosteroids. Following discovery of a testicular mass, he underwent testicular ultrasonography which demonstrated bilateral hyperechoic lesions. Histological examination of an open surgical biops...

Aim: To analyse outcome of transsphenoidal surgery for acromegaly in Wales using stringent remission criteria.Method: We retrospectively analysed 90 patients who underwent transsphenoidal surgery (performed by 3 surgeons) as initial therapy for acromegaly in our centre between January 1980 and December 2001. A combination of modern, evidence-based remission criteria including mean day curve GH < 5 mU/l and /or a nadir GH < 2 mU/l after an oral glucose tolerance test ...

Pituitary apoplexy is a potentially life and vision threatening neuroendocrine emergency, which can often be misdiagnosed in the absence of the clinical hallmark of sudden onset headache and visual disturbance in a patient previously known to harbour a pituitary tumour. We report a 30 years old male patient with history of Vitiligo who presented to the emergency department with a 1-week history of vomiting, abdominal pain and lethargy along with postural hypotension and a very...

Obesity and excess adiposity may occur following treatment for childhood acute lymphoblastic leukaemia (ALL) even in those not administered cranial irradiation. Prior glucocorticoid treatment may be contributory as glucocorticoids have direct effects on fat mass (FM) and adipocytes. From 1997 to 2003 children treated for ALL in the UK were randomised to receive either prednisolone or dexamethasone.Objectives: In survivors of childhood ALL not treated wit...

Introduction-Cushing's syndrome is characterised by hypercortisolaemia, loss of the diurnal rhythm of cortisol secretion and loss of negative hypothalamic-pituitary-adrenal (HPA) feedback. Patients with adrenal incidentalomas may manifest some signs of cortisol excess before developing overt Cushing's syndrome. This can be considered as 'Cushing's syndrome in evolution'.Case History-A 47 year old lady with ty...

We describe the case of two patients who presented with non-mechanical bowel obstruction as a consequence of an underlying, undiagnosed Phaeochromocytoma. The first patient was referred in to the surgical team by his GP with signs and symptoms of small bowel obstruction. He described abdominal pain, distension and vomiting and had not opened his bowels for a week. The X-ray supported the clinical diagnosis and he went on to have an abdominal CT scan. The scan did not identify ...

Introduction:: Advances in MDT working in Disorders of Sexual Development (DSD) are supported by activities which call for national and international collaborations. In the EuroDSD programme we are collecting clinical data and performing functional studies to assess the pubertal outcome of PAIS patients raised male.Methods: Clinical information including birth phenotype, surgery, medication and pubertal outcome, from 16 post pubertal PAIS patients with k...