Endocrine Abstracts

Case history: A 52 year old lady presented to her GP with a 2 year history of headaches, anxiety and loose stools. The GP found lid retraction and fine tremor but no goitre. Her heart rate was 100. Her GP sent blood for thyroid function tests and results showed a TSH of <0.03 mu/l and free T3 of >30.8 pmol/l. She was started on propranolol 40mg thrice daily and referred to endocrinology. In clinic she described palpitations whilst watching TV and sweatiness. She had su...

Abstract learning objective: Resistance to thyroid hormone is a rare condition caused by tissue refractiveness to the effects of circulating thyroid and may be misdiagnosed as hyperthyroidism. This syndrome is characterized by elevated circulating thyroid hormones, and unsuppressed TSH levels. Although most patients are euthyroid, rarely they may present with clinical hyperthyroidism, if the Pituitary gland is more insensitive than other tissues to thyroid hormones.<p clas...

Background: A 58-year-old male known to have hypertension since 2002 was initially treated with Furosemide and Bendroflumethiazide but was stopped due to hypokalemia. Blood pressure was controlled with Ramipril, Atenolol, Doxazocin and Amlodepine. He was found to be persistently hypokalemia ranging from 2.7 to 3.3 mmol/l.Investigations: Aldosterone: 250 ng/l, renin: <2.3 mU/l, aldosterone:renin ratio: >108, 24 h urine catecholamines×2: norma...

A 67 y old man was brought to the A & E department after being found unresponsive. He was drowsy, hypotensive (BP 90/ 60 mmHg) and had low blood glucose of 1.2 mmol/L. Serum Na was 126 mmol/l (135–145) and K 3.5 mmol/L (3.5–5.0). CXR showed a left basal consolidation. Intravenous 10% dextrose and antibiotics were given. Twenty two years prior, he was diagnosed with squamous cell carcinoma of nasal septum associated with nodal involvement in the neck. He underwent...

Background: Atypical carcinoid tumours are rare which account for about 15% of all carcinoid tumours. Some of those tumours secrete adrenocorticotrophic hormone (ACTH) causing Cushing's syndrome. We present a case which recurred 16 years after being first diagnosed.Case: A 39 years old woman was referred with few months history of weight gain, irregular menstrual periods, muscle aches, difficult going up the stairs, headaches and blurred vision.She was i...

Sertoli-Leydig cell tumours are rare comprising 0.2–1.2% of all primary ovarian cancers. Virilisation is seen in 30–50% of cases. Heterologous Sertoli-Leydig cell tumours with dominant cystic component are even rarer and mainly affect females aged 20 to 30 years. A 66-year-old lady was referred to the Endocrine Department with a one year history of rapid severe hirsutism involving the limbs, abdomen, chest, face and thinning of hair on the scalp. Blood pressure of 15...

Case History: A 61-year-old Caucasian female from Ukraine presented with severe hypercalcaemia following routine blood tests performed by the GP. She reported symptoms of back pain and joint pains. She had renal stones 10 years prior. No history of thiazide or lithium use. No red flags; no change in appetite or weight loss. There was no familial history of Multiple Endocrine Neoplasia (MEN). Examination of her neck, cardiorespiratory, abdomen and breasts were normal. <p cl...