Endocrine Abstracts

A 31-year-old German lady attended A&E with a 1 week history of bilateral leg swelling. The leg swelling had been gradual in onset and was not associated with shortness of breath, chest pain or haemoptysis. She had no history of renal or cardiac disease. Her only past medical history was of mild indigestion. She did not have any regular medication use. On examination she was systemically well but had bilateral pitting lower limb oedema. Blood pressure was 120/80 mmHg (comp...

Introduction: A recent meta-analysis has suggested that combined replacement with Liothyronine (T3) and Levothyroxine (T4) confers no additional benefit to patients with hypothyroidism but patients still occasionally request this treatment approach.Aim: To analyse the indications and biochemical characteristics of patients on T4/T3 combination therapy for Hypothyroidism in our cohort of patients.Methodology: A retrospective search ...

Background: Metformin is increasingly used in the management of polycystic ovary syndrome (PCOS) but there remain differences in opinion as to its precise role in terms of clinical benefit. We retrospectively reviewed the effects of metformin on menstrual regularity, fertility, weight and hirsutism in 244 patients with PCOS treated routinely with metformin in our clinics.Results: Patients were of median age 27 years (range 12–47) with median BMI of ...

Adrenocortical carcinoma is extremely rare and accounts for 0.05–2% of all malignant neoplasms with an estimated incidence of 0.5–2% per million people per year. Feminising adrenal carcinoma is even rarer. We submit such a rare case presenting with gynaecomastia.A 50 year old man presented with a year history of increasing bilateral gynaecomastia. He had no problems with his sexual function. Initial investigations by the GP showed low testoster...

Background: The role of post-operative radiotherapy (RT) in the treatment of non-functioning pituitary adenomas (NFA) remains controversial. We compared the difference in outcome between patients receiving transsphenoidal surgery (TSS) alone and TSS plus RT in 93 patients treated for NFA between 1986 and 2005. 64 (69%) had TSS alone whilst 29 (31%) received TSS plus RT (45GY, 25Fr, 3 field). All patients were followed up by CT and then MRI scans repeated at increasing interval...

The differential diagnosis of post-partum thyrotoxicosis includes Graves' disease and post-partum thyroiditis(PPT). We present two cases which demonstrate the difficulty of interpreting 99mTc-pertechnetate scans in this setting. Case 1 is a 37 year-old lady who presented 5 months post-partum with a month history of palpitations, sweating and heat intolerance. Investigations revealed TSH < 0.01 mU/L, fT3 8.9 pmol/L (NR 10.5-22.7 pmol/L) and fT4 23.4 pmol/L (NR 3.5-6.5 pmol/)...