Endocrine Abstracts

Introduction: A 28-year-old primigravida developed increasing hairgrowth in androgen sensitive areas in the first trimester of her first pregnancy. She was previously well with menarche at 14 years, normal periods thereafter and no difficulty in conceiving. She took no medication. Clinically, at 34 weeks gestation she had significant hirsutism of her face, arms, legs and a prominent male escutcheon. She was obese but not Cushingoid.Investigations and res...

Introduction: Significant hypoglycaemia is a rare but well recognised presenting feature of secondary adrenal insufficiency. Such hypoadrenalism may be caused by intrinsic hypothalamo-pituitary disease (pituitary adenoma), exogenous steroid therapy, and uncommonly by hypophysitis and pituitary secondaries from malignant disease.Case presentation: A 73-year-old woman presented acutely with confusion, agitation, and a...

Introduction: Significant hypoglycaemia is a rare but well recognised presenting feature of secondary adrenal insufficiency. Such hypoadrenalism may be caused by intrinsic hypothalamo-pituitary disease (pituitary adenoma), exogenous steroid therapy, and uncommonly by hypophysitis and pituitary secondaries from malignant disease.Case presentation: A 73-year-old woman presented acutely with confusion, agitation, and a...

Introduction: Despite high rates of recurrence after anti-thyroid drug (ATD) withdrawal, ATD (mainly Carbmazole) remain the first line of treatment for Graves’ disease (GD) in the UK. Limited retrospective observational studies have shown that a low TSH post ATD withdrawal had a positive predictive value of 70% and a negative predictive value of 62% (specificity 85%) for relapse of Graves’ disease.Aim: We wished to determine the relationship be...

Introduction: Graves’ disease (GD) is associated with a number of cardiovascular complications, including rhythm disturbances, mitral valve prolapse, pulmonary hypertension and heart failure. Pericardial effusion in the context of GD has only been reported in a small number of cases.Case: A 59-year-old gentleman presented with a 3-day history of dyspnoea and pleuritic chest pain. He had a previous history of GD 8 months ago, pulmonary embolism (PE),...

Case history: A 24-year-old previously healthy male presented to his GP with unilateral “gynaecomastia”, prompting investigations which showed a low FSH of 0.7 (1–12 IU/l). He had normal libido, erectile function, and a normal sense of smell. He had no children. He was subsequently investigated for persistent dysuria but imaging and cystoscopy were entirely normal. He was a non-smoker who took little alcohol and worked as an insurance agent. His past medical his...

Case history: A 53-year-old obsessive body builder, presented with severe constipation. He had used growth hormone, anabolic steroids and testosterone at variable doses for over 20 years. He had a protein intake of over 400 g/day over an extended period. He denied osmotic symptoms, joint or muscle pains, and excessive tiredness. Previously, he had benign prostatic hyperplasia and renal stone disease but was not on any prescription medication and took no over the counter ‘...

Introduction: The polycystic ovary syndrome is the commonest cause for hyperandrogenism in young women. However, in older women, adrenal and ovarian tumours are more common, particularly if (a) hyperandrogenism is of short duration, (b) causes significant clinical androgenisation, and (c) is biochemically severe. We present an elderly woman who presented diagnostic and therapeutic challenges on account of her comorbidities.Case Present...

Introduction: There is no consensus about the management of thymic enlargement in Graves’ disease (GD). If imaging indicates ‘benign’ thymic appearances, and interval scans are stable, most authorities advocate no intervention until thyrotoxicosis is controlled. We present 3 patients with GD and incidentally found thymic enlargement.Case presentations: a. A 37-year-old female presented acutely with osmotic symptoms, a weight ...

Introduction: The polycystic ovary syndrome is the commonest cause for hyperandrogenism in young women. However, in older women, adrenal and ovarian tumours are more common, particularly if (a) hyperandrogenism is of short duration, (b) causes significant clinical androgenisation, and (c) is biochemically severe. We present an elderly woman who presented diagnostic and therapeutic challenges on account of her comorbidities.Case Present...