Endocrine Abstracts

Cranial Diabetes Insipidus is a potentially fatal disorder if not diagnosed and treated appropriately. The diagnosis can either be made in the outpatient setting, whereby the main differential diagnosis is Primary Polydipsia (PP), or during a hospital admission, where patients can be prfoondly unwell, dehydrated and hypernatraemic. In the ouptatient setting, it can sometimes be difficult to distinguish between DI and PP, but usually severe Cranial DI is clinically and biochemi...

Cranial Diabetes Insipidus is a potentially fatal disorder if not diagnosed and treated appropriately. The diagnosis can either be made in the outpatient setting, whereby the main differential diagnosis is Primary Polydipsia (PP), or during a hospital admission, where patients can be prfoondly unwell, dehydrated and hypernatraemic. In the ouptatient setting, it can sometimes be difficult to distinguish between DI and PP, but usually severe Cranial DI is clinically and biochemi...

Background: Incidentally discovered pituitary lesions are a common problem in the endocrinology clinic due to increased access to detailed brain imaging. The challenge for endocrinologists is to determine which pituitary lesions are clinically significant and which are truly incidental. Pituitary micro-adenomas have been found at autopsy in 1.5–27% of subjects, whilst population-based radiological studies report small pituitary lesions in ~10%. It is difficult to produce ...

A 48-year-old gentleman was admitted to AMU overnight in January’12 from eye casualty with weeks of worsening visual disturbances followed by rapid deterioration – complete loss of vision in the right eye and a temporal hemianopia on the left side but no headache.Urgent hormone profile revealed elevated prolactin 53 988 mU/l, low testosterone of 3.3, SHBG 22, LH 2, FSH 3.1, IGF1 292, satisfactory SST (0 min cortisol 213 with ACTH 10 and 30 min ...

Pseudohypoparathyroidism during pregnancy can lead to challenging calcium fluctuations and can lead to maternal and foetal morbidity. There are limited case reports and no established management guidelines. Maintaining calcium level in healthy range during pregnancy is required to minimise the risks of associated complications. We report a case of Pseudohypoparathyroidism type 1a in 30 year old lady, who was initially referred to us by her general physician with calcium, of 1....

A 40 year old lady presented to GP with few months history of palpitation, anxiety, frequent stools in April’15. Clinical examination revealed moderate sized goitre, more prominent on right side, mobile, non-tender and no lymphadenopathy. Blood tests consistent with T3 toxicosis with FT3 10 (3.5–6.5), FT4 21 (9–25), TSH <0.05 (0.3–5.0) and thyroid peroxidase antibody positive at 562 IU/ml (0–60). Initiated on Carbim...

Background: Patients with Phaeochromocytomas (PCC) have been found to carry germline mutations in 40% of cases. The number of known susceptibility genes has risen sharply in recent times, from six to sixteen since 2009. We present a patient who was found to have a mutation in Myc Associated Protein X (MAX), one of the newly identified inherited susceptibility genes.Case Presentation: A 16-year-old female presented with paroxysmal episodes suggestive of c...

Background: Patients with Phaeochromocytomas (PCC) have been found to carry germline mutations in 40% of cases. The number of known susceptibility genes has risen sharply in recent times, from six to sixteen since 2009. We present a patient who was found to have a mutation in Myc Associated Protein X (MAX), one of the newly identified inherited susceptibility genes.Case Presentation: A 16-year-old female presented with paroxysmal episodes suggestive of c...

This case shows the potential unreliability of a single ACTH assay in the context of Cushing’s syndrome and need for better ways of measuring ACTH and precursors. A 35 year-old lady presented with severe abdominal pain and cushingoid features. CT scan showed a 2.9 cm right adrenal nodule. Investigations: 24-hour UFC 446 nmol/l, post-dexamethasone cortisol level of 572 nmol/l. The referring hospital found a suppressed ACTH < 0.1ng/l consistent with ACTH-independent Cus...

Case: A 69 year old gentleman with a past medical history of essential hypertension presented to medical services with symptoms of weight loss, muscle weakness and fatigue. Following blood tests, a CT scan, liver biopsy and biochemical screening, a metastatic phaeochromocytoma was diagnosed. He was commenced on alpha and beta blockade. Further imaging, including a MIBG scan, showed non-resectable disease therefore he underwent therapeutic MIBG treatment. Following a good respo...