Endocrine Abstracts

A 57-year-old woman was referred due to elevated urine & serum human chorionic gonadotrophin (β-hCG) concentrations found at routine pre-operative assessment. She was asymptomatic and was not pregnant. Her past history included a long standing benign 7 cm×5 cm myofibroblastic mass in her left forearm asthma, rotator cuff tear and a uterine fibroid. Her medications were cyclical norethisterone, lansoprazole, frusemide & inhalers. The left forearm mass was not ...

Twenty-two years old pharmacy student was urgently referred from primary care with a history of recent weight gain of 15 kg and an elevated 24 h urinary free cortisol (UFC) of 4517 nmol/l (<330). Clinically she described increasing hirsutism, low mood, loss of libido and symptoms suggestive of proximal myopathy.Her past medical history included recurrent low impact wrist fractures, asthma, PCOS, depression and epilepsy.On exami...

Introduction: α 19-year-old female patient with no past medical history presented with multiple collapses following exercise due to hypoglycaemia. From the history it transpired that she had had previous symptoms consistent with hypoglycaemia on multiple occasions, with no relation to fasting or food or a specific diurnal or nocturnal pattern. The two most severe episodes (requiring paramedic treatment) were in the recovery period from anaerobic exercise. Her body mass in...

Introduction: The psychiatric consequences of inoperable Cushing’s syndrome can be difficult to manage medically. Etomidate, an imidazole derived anaesthetic agent, inhibits cortisol synthesis and may be useful in this circumstance.The case: A 57-year-old woman presented with symptoms and signs of hypercortisolism. She gave a history of recent onset intermittent right sided stabbing chest pain and worsening breathlessness.Two ...

Materials and methodsTwenty-eight men with erectile dysfunction (ED) were investigated with TT, SHBG, albumin, fasting blood glucose, hormonal profile and a lipid profile. Free testosterone and bio-available testosterone (BAT) were calculated in all men using the calculator on the ISSAM website (http://www.issam.ch/freetesto.htm).Results: The mean age was 55...

Context: Despite the widespread use of the short synacthen test (SST), there remains no clear consensus on sampling times for the measurement of serum cortisol that best determines adrenal reserve.Objective: To establish whether there is any value in measuring serum cortisol at 60 minutes following administration of synacthen.Design and setting: Retrospective data analysis of 500 SST results measuring 0, 30 and 60 minute cortisol l...

A 43-year-old man presented with aching legs, gynaecomastia, erectile dysfunction, central obesity, and generalised hair loss. Examination confirmed these findings as well as showing him to be hypertensive at 160/100 mmHg. Routine haematology and biochemistry as well as levels of anterior pituitary hormones were normal, except for an inappropriately low TSH in the face of normal T3 and T4 levels. A pituitary MRI showed the presence of an ill defined area of reduced signal inte...

Introduction: Laparoscopic adrenalectomy is the gold standard treatment for adrenal lesions. High volume centres with input from endocrinologists and urologists with a special interest in adrenal lesions may have best outcomes. Aims: To audit our practice and set standards with reference to preoperative workup and postoperative follow-up. This is a single centre, single surgeon experience of surgical adrenalectomy.Material & Method: Over a 10 year pe...

Background: Hyperosmolar hyperglycaemic state (HHS) is an acute metabolic complication of diabetes that can lead to significant morbidity and mortality if managed incorrectly. With <1% prevalence, there is limited published literature available on HHS and most management guidelines worldwide are based solely on expert advice and opinions.Aims: To study the precipitating causes and identify baseline practises of HHS management, to highlight areas for ...

Introduction: Insulinomatosis is a rare disorder characterised by persistent hyperinsulinaemic hypoglycaemia (PHH) due to the occurrence of multifocal pancreatic insulinomas. This condition, whose pathogenesis is unknown, can occur in a familial setting. Paradoxically, while some family members develop PHH, others develop diabetes mellitus.Methods: We have identified a family with autosomal dominant familial insulinomatosis and diabetes. Exome sequencing...