Endocrine Abstracts

Introduction: In Endocrinology, subclinical disorders meet certain diagnostic laboratory thresholds, but are by definition asymptomatic. Subthreshold disorders in Endocrinology have not been defined. We describe two cases of cortisol deficiency, primary and secondary, with normal baseline cortisol, which were by presentation clinical, but could be characterized as subthreshold by biochemical cut-off criteria.Case 1: A 47-year-old woman was referred for a...

Introduction: rhPTH(1-84) replacement is the treatment of choice in adults with hypoparathyroidism not adequately controlled on standard therapy. Although increased bone turnover markers have consistently been reported in trials of safety and efficacy, marked elevations coupled with significant symptoms have been rare. We describe a case of increased treatment-induced bone turnover, necessitating significant therapeutic adjustments and monitoring.Case re...

Introduction: Nelson’s syndrome is a rare complication of Cushing’s disease treated with bilateral adrenalectomy. There is no effective medical treatment yet. Nelson’s patients respond to hypothalamic stimuli distinctly from patients with Cushing’s disease and those with Addison’s disease. We describe the responses to standard ACTH stimulation tests in a patient with Nelson’s syndrome.Case report: A 42-year-old woman present...

Introduction: With the advent of modern imaging, up to 30% of adrenal pheochromocytomas are discovered incidentally in asymptomatic patients. Smaller tumors may be ‘pre-biochemical’ in their secretory capacity, but truly nonfunctioning tumors over 3 cm are exceedingly rare. We describe a case of a clinically and biochemically silent pheochromocytoma.Case report: A 65-year-old woman was found to have a left adrenal incidentaloma on an abdominal ...

Introduction: Sweet’s syndrome is a rare, acute febrile neutrophilic dermatosis, associated with a variety of inflammatory and neoplastic conditions, drug reactions and rarely with a spectrum of thyroid dysfunction. A possible link between thyroid autoimmunity and Sweet’s syndrome has been previously suggested by rare reports of Hashimoto’s thyroiditis, subacute thyroiditis and classic Graves’ disease. We describe a case of ‘atypical’ hyperthyroid...

Background: Assessment of hypothalamic–pituitary adrenal axis in patients with schizophrenia is complex, as it involves both the disease process and antipsychotic medications. We present a case of a patient on long term clozapine with a concomitant pituitary adenoma who presented discordant responses to adrenal stimulation.Case: A 38-year old male was referred with chronic symptoms of reduced libido and associated low testosterone levels. He was tre...

Introduction: Chest computed tomography imaging in patients with Covid-19 infection often reveals incidental adrenal lesions, which are subsequently investigated, after recession of the infection.Purpose: Description of a pheochromocytoma that was accidentally diagnosed in a teenager, during her hospitalization with Covid-19.Case description: A 17-year-old girl, who was diagnosed with covid-19 infection, by molecular testing 6 days...

Introduction: Various methods to quantify calcified coronary plaque have been used in common clinical practice in the past few decades to compliment cardiovascular risk assessment. The estimation of calcium load in other organs and conditions has been at best semi-quantitative. Patients with long-standing hypoparathyroidism are known to suffer with nephrocalcinosis and basal ganglia calcification. We attempted to quantify end-organ calcium burden in a series of patients with v...

Introduction: Adrenal ganglioneuroma (AGN) is a rare (about 470 described cases), benign tumor arising from the neural crest tissue. These tumors are usually asymptomatic and incidentally detected. They have variable radiological features that often raise suspicion of malignancy. AGN are diagnosed at a mean age of 50 years, have no gender preference and are rarely associated with genetic syndromes.Aim: The presentation of two male patients, 24 and 53 yea...

Introduction: Idiopathic Isolated Adrenocorticotropic hormone (ACTH) deficiency (IIAD) is a rare cause of secondary adrenal insufficiency. It can present with a variety of clinical symptoms, mainly chronic fatigue and euvolemic hyponatraemia, and may coexist with autoimmune disease, most commonly Hashimoto’s thyroiditis. Radiographically, an empty sella turcica image can be seen. We present 3 cases of isolated ACTH deficiency.Case 1: A 47-year-old w...