Endocrine Abstracts

Histiocytosis X is a rare disorder in which proliferating Langerhans cells can infiltrate virtually any site in the body. Bone is the most commonly affected site but endocrine involvement is frequently seen. Diabetes insipidus is the most common abnormality when there is involvement of the hypothalamic-pituitary axis.We report the case of a 42 year old lady who presented with diabetes insipidus in 1997. MR scan of the pituitary showed absence of the post...

65 yr female presented with headaches, heat intolerance and loose stools. She had cerebrovascular accident, osteoporosis and vitiligo. A 24 hr ECG revealed atrial flutter with heart rate upto 117 beats /minute. Her medications include warfarin and bisoprolol.A Thyroid function test (TFT) revealed Free T4 (Ft4): 32 pmol/L (9-19) Free T3: 7.97 pmol/L (3.6–6.5), TSH: 5.7 mU/L (0.35–4.94). Other anterior pituitary function tests were ...

65 yr female presented with headaches, heat intolerance and loose stools. She had cerebrovascular accident, osteoporosis and vitiligo. A 24 hr ECG revealed atrial flutter with heart rate upto 117 beats /minute. Her medications include warfarin and bisoprolol.A Thyroid function test (TFT) revealed Free T4 (Ft4): 32 pmol/L (9-19) Free T3: 7.97 pmol/L (3.6–6.5), TSH: 5.7 mU/L (0.35–4.94). Other anterior pituitary function tests were ...

A 72-year-old man presented with a two-year history of hot sweats, impotence and mood swings. He had a past medical history of polymyalgia rheumatica, osteoporosis and mild hypercalcaemia.On examination he was sweating excessively, had testicular atrophy and mild hypertension. Blood tests revealed a raised LH, FSH and a low testosterone consistent with primary hypogonadism. Hypercalcaemic screen was negative. He was started on androgen replacement therapy as well as anti-h...

Objective: To assess the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of sonographic index point and resistivity index in predicting the risk for malignancy in thyroid nodules.Methods: Fifty consecutive patients undergoing thyroid ultrasound for clinical nodular thyroid diseases prior to planned surgery were recruited for the study. Sonographic index point was calculated for each nodule using morphological...

A 57 year old Caucasian woman complained of severe back pain and arthralgia of large joints. Her arthralgia gradually got worse and she also noticed proximal muscle weakness. Blood tests showed normal CRP but elevated alkaline phosphatase of 521 iu/l with normal Gamma GT. Phosphate was low at 0.75 mmol/l with normal corrected calcium of 2.6 mmol/l. A DEXA scan suggested osteoporosis (Spine T −2.5). Isotope bone scan revealed increased activity in the right tibia and plai...

A 68-year-old woman presented with hypertension, oedema, weight gain and moon face. She had signs of proximal muscle weakness, thinning of scalp hair and bruising on her legs. Initial tests showed 24 hour urine free cortisol elevated at 946 nmol (0–300 nmol).Serum cortisol showed no circadian fluctuation (0900: 1094 nmol/l, 2400 hrs: 886 nmol/l) and no suppression by dexamethasone (2 mg/24 h for 48 h: 1067 nmol/l). ACTH levels were slightly raised (...

A 36-year-old male presented to neurologists with tiredness and clumsy gait. Examination revealed normal cranial nerves, spastic paraparesis and bilateral extensor plantar response, absent vibration sense and ataxia. He was thought to have an inherited form of Spino-Cerebellar ataxia. His mother had developed similar neurological problems in her 50 s, and his maternal uncle had Addison’s disease.He was referred to endocrinologists because of the fin...

Pituitary apoplexy is an acute medical emergency but there are no evidence based management guidelines, especially for neurosurgical intervention.A 35-year old male presented with sudden onset severe headache. On examination blood pressure was 180/120 without any lateralising neurological signs. He appeared acromegalic with a short history of enlarging hands & feet. Emergency CT scan and a MR scan later confirmed haemorrhagic pituitary adenoma, 3 cm ...