Endocrine Abstracts

Section 1: Case history: We present the case of a 35-year-old gentleman referred by his GP to Endocrinology clinic for loss of libido and testosterone deficiency. His co-morbidities included obesity (BMI 59 kg/m2), hypertension and obstructive sleep apnoea (OSA) requiring overnight continuous positive airways pressure (CPAP) therapy. Routine pituitary profile showed luteinising hormone 4.8 IU/l (1–8), testosterone 7.1 nmol/l (8–25), prolactin 232 mU/l (86&...

Malignancy-related hypercalcaemia occurs in over 20% of cancer patients. Most cases are due to enhanced production of parathyroid hormone-related peptide (PTHrP) by tumours and carry a poor prognosis of survival of weeks to months. A 74 year old man with a history of prostate cancer treated with radical radiotherapy in 2013 and androgen blockade until 2015 underwent CT and PET/CT scans in 2017, which showed liver and spleen abnormalities, suggestive of metastases, but unlikely...

Case History: 17 year old boy presented with a six week history of polyuria, polydipsia, headaches and easy fatiguability. Further investigations confirmed hypopituitarism with low early morning urine osmolality. MRI brain revealed soft tissue mass arising from tectal plate extending into cerebral aqueduct resulting in hydrocephalus with normal pituitary gland. Hydrocortisone, Levothyroxine and Desmopressin were started and urgent in-patient transfer to Neurosurgical unit in t...

Section 1&2: Case history and investigations: Primary hyperparathyroidism is a rare condition in pregnancy. The occurrence rate is about 1 % and up to 80 % of the patients are asymptomatic. Clinical symptoms are nonspecific. However, severe maternal, foetal and neonatal complications including neonatal death have been reported in literature. 27 years old Asian lady presented to Emergency Department with abdominal pain in July 2019. She was found to have raised calcium at l...

Case History: 29 year old lady presented with profuse diarrhoea, lethargy and hypokalaemia in 2010. CT scan confirmed mass lesion in tail of pancreas. Chromogranin A and 24 hour urinary 5HIAA were normal. Fasting Gut hormone level showed elevated level of Vasoactive Intestinal Peptide (VIP), suggesting diagnosis of VIPoma. Further investigations confirmed hyperparathyroidism and microprolactinoma. Investigations: Adjusted calcium 2.98 mmol/l (<2.55), ...

We present a case of a 44-year-old female with fluctuating thyroid function over 12-14 years. The patient originally presented with a high TSH, normal free T3/T4 and a negative anti-TPO antibody. She was initially monitored, then went onto Levothyroxine replacement in an antenatal setting. Subsequently, 12-18 months later, she presented with hyperthyroid symptoms and vastly elevated TSH-receptor-antibody (TSHR-ab) titre of >10 IU/L, the upper limit of normal being 2.9 IU/L...

A recent case series commented on adverse COVID-19 outcomes among patients with Cushing’s syndrome, despite minimal symptoms and low inflammatory markers. Excessive glucocorticoids can impede adaptive immune response to viruses, leading to increased infection risks (1). Sarker et al discussed glucocorticoids binding to viral spike-proteins, inhibiting receptor interactions and contributing to prolonged positive swabs, in the absence of symptoms (2). We report the c...