Endocrine Abstracts

A 45-year-old Caucasian man with BMI of 34 presented with a few years’ history of low libido and premature ejaculation. He had azoospermia in the past for infertility investigation 4 years ago with his previous relationship. His LH and FSH were high at 18 U/l(2-13 U/l) and 10 U/l(2-9 U/l) while his 9 amtestosterone level was 19.2 nmol/l(10-38 nmol/l) along with normal prolactin and TSH. The testicular examination is unremarkable. His repeat semen analysis shows azoospermi...

A 41 year old lady was referred to the endocrine clinic by her respiratory physician. She is known to have Langerhans cell histiocytosis (LCH) with lung involvement. She is having yearly follow up under respiratory team and not needing any treatment for LCH. In endocrine clinic she confirmed that she is drinking around 9 to 10 L of water / day and having quite significant polyuria. She works in Tesco. She does not have any other medical condition and not taking any regular med...

A 71 year lady, who has past history of acute ischaemic stroke ( now bed bound and can only get out of bed with the help of a hoist) , Type 2 diabetes melitus, HTN, CKD and high lipid. She is on Metformin 1 gm twice daily, Ramipril 5 mg at night, Clopidogrel 75 mg od, Atorvastatin 80 mg od. She was brought to hospital by unexplained drowsiness and poor oral intake. Her blood sugar was 72, ketone 5.2, Ph: 7.21, Na: 165, Urea 14 and calculated osmolality of 412. Her chest xray a...

Hyponatraemia is the commonest electrolyte disturbance among inpatients. Prompt diagnosis and management of the underlying cause is important. A 49-year-old Caucasian male presented to the emergency department with a two-day history of fever, altered mental status, vomiting, diarrhoea and postural dizziness. A rapid point of care RT-PCR test resulted positive for the SARS-CoV-2. A provisional diagnosis was presented of COVID-19 encephalopathy. The patient was usually fit and w...

We report a 33 year old female who presented at 23 weeks gestation with rapid onset polyuria and polydipsia. Fluid input and output was approximately 12 litres per day. She denied any other symptoms. She did not have signs of hypopituitarism, Acromegaly or Cushing’s syndrome. Visual fields were normal to confrontation. Her standard glucose tolerance test, Hba1c, creatinine and calcium were normal. Gestational Diabetes Insipidus was (GDI) suspected. Given her pregnancy, a ...

We report a 45-year-old man who developed acquired primary hypoparathyroidism based on a low serum adjusted calcium level and low parathyroid hormone level. His past medical history included recurrent chronic anaemia requiring multiple transfusions since 2011. He was an ex- intravenous drug user, and suffered from chronic bilateral venous leg ulcers, and liver cirrhosis following Hepatitis C infection. Despite using doses of up to 8 mcg Calcitriol daily, his calcium levels fel...

Background: Graves’ disease is widely treated with anti-thyroid medication. After an initial course of treatment, remission is achieved in around 50% of patients. Definitive treatment is generally offered in relapsed cases, based on the assumption that remission rates following a second course of anti-thyroid medication are significantly lower.Method: A database of patients with Graves’ disease has been kept from 2004. 150 patients were suitabl...

Incidentally discovered adrenal masses on abdominal imaging for unrelated reasons have a prevalence of 1-7%. A great majority of these are non-functioning adenomas, but 5-30% are associated with autonomous cortisol secretion (ACS), which is mainly subclinical, and 1-5% with phaeochromocytoma or Conn’s syndrome. Here we report two cases of overt functioning adrenal adenoma with coexisting ACS. We could not find any other reports of such cases in the literature.<p class...

Introduction: There are reports of patients having co-existing primary hyperparathyroidism and familial hypocalciuric hypercalcaemia (FHH). The combination of relative hypocalciuria, hypercalcaemia and slightly elevated serum parathyroid hormone (PTH) could indicate FHH. Medications such as, lithium and bendroflumethiazide can reduce renal excretion of calcium. We report a case highlighting the importance of being aware of drug-induced hypocalciuria during the investigation of...

Case History: A 70-year-old man of Chinese origin presents with a two-month history of worsening visual acuity and double vision. He denied systemic symptoms apart from marginal weight loss. Other medical history includes stable asthma, treated with inhalers. He has a niece and nephew with thyroid disease. He is an ex-smoker, retired accountant, and drinks occasional alcohol. On examination, he was normotensive with a body mass index of 22 kg/m2 however was found to...