Endocrine Abstracts

Addisons disease is a rare but potentially life threatening endocrine disorder. It is well-known for disguising as a variety of presentations before diagnosis. Here we present a case report of Addison’s disease presenting with very severe hyponatraemia. A 35 year old lady was admitted with lethargy, low mood, weight loss and feeling generally unwell for the last 3 months. Six weeks prior to her admission, her GP arranged some routine investigations including U&E which...

MEN2a is a rare genetic endocrine disorder associated with mutation of RET oncogene on chromosome 10. It involves lesions in thyroid, parathyroid and adrenal glands. Medullary thyroid carcinoma is the pathological hallmark and usually the first presentation of this syndrome.Clinical case: A 64-year-old lady with previous history of hypertension, IHD, and hypercholesterolemia was referred to Endocrine clinic after she was incidentally found to have high c...

A 17 year-old female was referred to Endocrinology with primary amenorrhoea and arrested puberty (B4 PH4 AH2). She reported breast development in line with her peer group and had experienced a single “show” of vaginal spotting aged 15 years. Although guidelines recommend baseline pelvic USS in the investigation of primary amenorrhoea, it generally only adds value in females with high LH+FSH and abnormal karyotype; indeed, it may raise undue concerns of uterine (Mulle...

Phaeochromocytomas are rare catecholamine secreting tumours arising from the chromaffin cells of the adrenal medulla. The annual incidence is approximately 0.8 per 100,000 person-years. Most of them are sporadic but in about 25–30% of patients, they are part of a familial disorder. The classic clinical features are episodic headache, sweating and tachycardia (with or without hypertension). However, a minority of patients are asymptomatic. We present a clinical case in whi...

Disorders of calcium metabolism are common in Sarcoidosis. The frequency of hypercalciuria and hypercalcaemia has been reported as 30–50% and 10–20% respectively. The underlying mechanism is enhanced PTH independent extra-renal production of 1,25-Dihydroxy Vitamin D (Calcitriol) which increase absorption of Calcium from the gut causing hypercalcaemia.A 79 year old lady was admitted with fever, cough and night sweats and was treated for pneumoni...

Alemtuzumab is the first humanised monoclonal antibody. It is used in haematological malignancies. It is associated with secondary autoimmune adverse effects including Grave’s disease, hypothyroidism, Goodpasture’s disease and ITP. We present a case where there was a drastic change in the thyroid biochemistry in a short span of few weeks- from raging free hormone levels to profound hypothyroidism. A 46 year old man was found to have abnormal th...

Introduction: Hypothyroidism remains a global problem with prevalence of 1–2% in iodine replete areas of the world. Primary or Autoimmune Hypothyroidism remains the most common type of hypothyroidism worldwide. Central (secondary) hypothyroidism (CH) because of pituitary/hypothalamic disorders is a rare cause of hypothyroidism with reported prevalence of 1:20.000 to 1:80.000 in the general population1. This makes CH about 1000 fold rarer than primary hypothyro...

We present an interesting case of a 50-year-old woman with previous history of alcohol dependence, depression & oesophagitis who was brought to the emergency department by ambulance with vomiting, back pain and feeling generally unwell. Her GCS was 14/15, HR128/min, RR 32/min, BP 111/60, temperature 35.2 & CBG 11.2mmol. She reported consuming one bottle of Vodka every day. Initial venous blood gas analysis showed severe metabolic acidosis (pH 6.79, HCO3 3, Lactate 15, ...

Female with primary hypogonadism have inadequate function of the ovaries, with impaired production of germ cells (eggs) and sex hormones (oestrogen and progesterone). We recently came across a 22-year old female with short stature in childhood and adulthood she received growth hormone treatment (due to arrested puberty) between 3-5 years of age and further treatment at age of 10 years. She had history of IUGR, primary amenorrhoea, sensorineural deafness, congenitally missing t...

A 59-year-old woman with 46XY complete androgen insensitivity syndrome was referred back to our service. She also has history of hypertension and migraines. She was gonadectomised at the age of 15 years and treated with Ethinylestradiol. She married and was able to have enjoyable sex without the need for vaginoplasty or dilators. However, at 54 years she was firmly advised to stop Ethinylestradiol due to satisfactory bone density and “risks of HRT outweighing benefits&#14...