Endocrine Abstracts

A 60-year-old gentleman known to suffer from atrial fibrillation (on warfarin therapy), hypertension and beta-thalassemia trait presented to the endocrine clinic for follow-up of hypothyroidism for which he was started on levothyroxine by his general practitioner about 2 years before. Serial thyroid function tests revealed a progressive reduction in thyroid stimulating hormone (TSH) levels in the setting of a decline in free thyroxine (fT4) levels. The patient denied any histo...

Subclinical hyperthyroidism is defined as low serum thyroid stimulating hormone (TSH) in the setting of normal levels of free T4 (fT4) and free T3 (fT3). Treatment for subclinical hyperthyroidism can be considered when TSH is persistently <0.1, particularly in (i) the presence of hyperthyroid symptoms, (iii) individuals aged >65 years, (iii) the presence of heart disease or osteoporosis. We present a case of a 34-year-old lady who was referred to endocrine outpatient c...

Adrenal insufficiency is a potential life-threatening condition due to lack of cortisol and early diagnosis and management is potentially lifesaving. We describe a 79-year-old lady who presented to the emergency department with new onset confusion, nausea, vomiting and decreased oral intake. Her relatives also reported a one month history of lethargy and weakness. She suffered from gastro-oesophageal reflux for which she was taking Ranitidine, and had a history of total abdomi...

A 38-year-old gentleman was referred to the endocrine clinic after a male fertility test done as part of investigation for infertility showed the following:Volume 4.4 mlTotal sperm number =6.16 Mill/ejacSperm concentration 1.4 Mill/mlProgressive motility 10%Nonprogressive motility 1%Impotence 89%55% sperm vitality<...

A 73-year-old gentleman known to suffer from hypothyroidism was admitted to hospital with severe symptomatic hyponatraemia of 112 mmol/l. He was acutely confused with a GCS of 12/15. He was found to be in urinary retention with 650 ml residual urine post catheterisation. Initially, his serum sodium concentration improved on catheterisation and fluid restriction. The syndrome of inappropriate ADH secretion in the context of urine retention was initially suspected on the bases o...

A 40 year old lady known to have type 1 diabetes on insulin pump therapy presented with hypertension at 33 weeks gestation. Treatment with labetalol 100 mg bd was initiated but she was admitted at 34 weeks due to lack of BP control. Sodium levels were 136 mmol/l (135–145 mmol/l) on admission. Labetalol was increased to 300 mg tds and she was discharged after 4 days with a sodium level of 129 mmol/l. She was readmitted at 35 weeks with pre-eclampsia as evidenced by severe ...

A 51-year-old lady known to suffer from Graves’ disease with associated orbitopathy since the age of 29 years, presented to endocrine outpatient clinic in view of recurrent symptoms of hyperthyroidism. She complained of heat intolerance, lethargy, tremor and diarrhoea. Appetite was normal and her weight remained stable. She had no worsening of visual symptoms. She was on carbimazole 5 mg daily since a year before. She had multiple courses of carbimazole in the past with s...

Aim: The sequelae of surgically treated pituitary adenomas (PAs) is an important area of study to help guide management. Our study aims to analyse all PAs, functional and non-functional, which were operated until the end of 2022 in a well-defined population and to identify radiological characteristics that can predict recurrence before operation.Methods: 206 PAs were evaluated along with their clinical, radiological, and histopathological characteristics...

Aim: Glucocorticoids play a significant role in inflammation and immune system disruption. Our study aimed to analyse different biochemical and blood count indices and serum inflammation-based scores in patients with all different causes of endogenous Cushing’s Syndrome (CS) in a well-defined population.Methods: Clinical records of 35 patients diagnosed with CS between 2008 and 2020 at the only central national health service hospital in Malta, were...