Endocrine Abstracts

Introduction: Hormone-secreting teratomas are well described. However teratomas secreting pancreatic hormones are rare, with even fewer cases producing clinically significant effects. We describe possibly the first documented case of hyperinsulinaemic hypoglycaemia due to an insulin-secreting ovarian teratoma.Case report: A 23-year-old woman presented with transient symptoms of lethargy and weakness. She had used her father’s capillary glucose meter...

Malignancy-related hypercalcaemia occurs in over 20% of cancer patients. Most cases are due to enhanced production of parathyroid hormone-related peptide (PTHrP) by tumours and carry a poor prognosis of survival of weeks to months. A 74 year old man with a history of prostate cancer treated with radical radiotherapy in 2013 and androgen blockade until 2015 underwent CT and PET/CT scans in 2017, which showed liver and spleen abnormalities, suggestive of metastases, but unlikely...

Case History: 17 year old boy presented with a six week history of polyuria, polydipsia, headaches and easy fatiguability. Further investigations confirmed hypopituitarism with low early morning urine osmolality. MRI brain revealed soft tissue mass arising from tectal plate extending into cerebral aqueduct resulting in hydrocephalus with normal pituitary gland. Hydrocortisone, Levothyroxine and Desmopressin were started and urgent in-patient transfer to Neurosurgical unit in t...

Clinical Case: A 48-year old male presented with gradual onset of shortness of breath and atrial tachycardia requiring admission to intensive care unit. He was normally fit and well and did not have any history of thyroid/neck surgery. He was an ex-smoker who drank more than 40 units of alcohol per week.Investigations: Laboratory tests revealed low serum calcium of 1.03 mmol/l (2.15–2.6 mmol/l), high serum phosphate of 2.77 mmol/l (0.9–1.50 mmo...

Case history: We present a 44 year old female with persistent severe burning itchy rash over the face, scalp and upper body for ten months. She was reviewed in multiple dermatology clinics and a diagnosis of chronic urticaria was made. Despite various treatments including antihistamines and steroids, symptoms persisted affecting her quality of life significantly.Investigations and diagnosis: Routine blood investigations revealed mild persistent elevated ...

Case history: We present the case of a 70-year-old female who presented to the Emergency Department with sudden onset inter-scapular and upper abdominal pain. She had been experiencing intermittent headaches, palpitations and constipation which had not previously been investigated. The only past medical history was of hypothyroidism. She had no significant family history. There was a discrepancy in the blood pressure between both arms. Admission blood pressure was elevated at ...

Case history: We present the case of a 72-year-old lady who presented to the surgical team with sudden onset abdominal (flank) pain. On initial assessment, she was significantly hypertensive (213/110 mmHg) and tachycardic (pulse 98 bpm) but afebrile. She was not on any anticoagulation. On physical examination, her abdomen was tender with mild guarding and retroperitoneal tenderness.Investigations: Admission blood tests showed a normal haemoglobin (149 g/...

A 71-year-old male patient with no significant past medical history was admitted to hospital with acute hepatitis in July 2014 with bilirubin 98 μmol/l, ALT 1703 IU/l, and ALP 223 IU/l. Liver ultrasound showed a normal sized liver with normal echotexture. Liver screen including hepatitis A, B, C, E, and autoantibody screen was negative. Liver biopsy revealed acute hepatitis with patchy necrosis and inflammatory infiltrate consistent with inflammation, drugs, or autoimmune...

Case History: 29 year old lady presented with profuse diarrhoea, lethargy and hypokalaemia in 2010. CT scan confirmed mass lesion in tail of pancreas. Chromogranin A and 24 hour urinary 5HIAA were normal. Fasting Gut hormone level showed elevated level of Vasoactive Intestinal Peptide (VIP), suggesting diagnosis of VIPoma. Further investigations confirmed hyperparathyroidism and microprolactinoma. Investigations: Adjusted calcium 2.98 mmol/l (<2.55), ...

We present a case of a 44-year-old female with fluctuating thyroid function over 12-14 years. The patient originally presented with a high TSH, normal free T3/T4 and a negative anti-TPO antibody. She was initially monitored, then went onto Levothyroxine replacement in an antenatal setting. Subsequently, 12-18 months later, she presented with hyperthyroid symptoms and vastly elevated TSH-receptor-antibody (TSHR-ab) titre of >10 IU/L, the upper limit of normal being 2.9 IU/L...