Endocrine Abstracts

A 37-year-old woman presented to ED with abdominal bloating and pain. Ultrasound abdomen showed a viable single intrauterine pregnancy at 24 weeks of gestation. Patient was surprised of the diagnosis as she had longstanding premature ovarian insufficiency (POI). She had stage 3B Hodgkin’s disease (HD) diagnosed at 14 years of age when she had BEAM chemotherapy (Carmustine, Etoposide, Cytarabine and Melphalan) followed by autograft bone marrow transplant for recurrent dise...

Introduction: Precocious puberty occurs is associated with initial increase in linear growth and acceleration of bone maturity presenting as advanced bone age with early epiphyseal fusion which ultimately results in short stature. ‘Van Wyk Grumbach Syndrome’ (VWGS) is a rare syndrome associated with incomplete isosexual precocious puberty and macroadenoma seen in cases of longstanding, untreated hypothyroidism is associated with a delayed bone age. Complete resolutio...

Case History: A 69-year-old lady was admitted to her local district general hospital with a history of confusion, memory disturbance and focal twitching affecting her upper limbs and face. She had a past medical history of type 2 diabetes mellitus, hypertension, hypercholesterolaemia and ischaemic heart disease. Her medications included gliclazide, pioglitazone, atorvastatin, bisoprolol, aspirin and omeprazole. She had never smoked and was teetotal. Neurological examination on...

Introduction: Cortisol insufficiency has been reported following cardiac surgery in infants but has not been associated with postoperative complications. In our hospital serum cortisol is measured following cardiac surgery when hypotension is refractory to two inotropes at maximal dose.Methods: Retrospective case note study to describe features of adrenal insufficiency in post-operative cardiac patients with low serum cortisol.Resu...

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...

A 30 year old lady attended the Accident and Emergency department (A&E) with vomiting, collapse and confusion several hours after completing her first London Marathon in 5 hours. During the race she kept herself hydrated with water and isotonic fluids and took non-steroidal anti-inflammatory drugs (NSAIDs). On arrival in A&E her Mini Mental Test Score was 0 and Glasgow Coma Scale (GCS) was 11. She was volume replete and haemodynamically stable but confused and restless...

A 20 year old Asian housewife presented with a history of irregular periods and six months subfertility. On May 1 2002 she had a prolactin of 2,200 mIU/L (normal range 63-211) and subclinical hyperthyroidism : thyroid stimulating hormone (TSH) 0.3mIU/L (normal range 0.4-5.5) and free thyroxine (fT4) 12.6 pmol/L (normal range 10.3-23.2). At her first hospital visit on September 9 2002 she was 9 weeks pregnant. She did not have hyperemesis gravidarum. On examination, she was cli...

Hypophysitis describes inflammatory pituitary lesions which can be classified into lymphocytic (autoimmune), granulomatous or xanthomatous. Rathke’s cleft cysts (RCC) are usually assymptomatic, benign tumours derived from remnants of Rathke’s pouch. We present a case of lymphocytic hypophysitis secondary to a ruptured RCC and the first reported case of post-surgical recurrence.A 34-year-old female presented with secondary amenorrhoea and fatigu...

Case history: A 69-year-old Caucasian male presented with persistent abdominal pain and was found to have a large right adrenal mass on CT. Interestingly his family history revealed that his daughter had been treated for Cushing’s disease. He was normotensive and denied classical symptoms of catecholamine excess. He had exertional dyspnoea in keeping with COPD. Subsequent tests were consistent with a secretory phaeochromocytoma and urine normetadrenaline 85,671 nmol/day (...

A 58 year-old Polish lady was admitted to hospital after having had two tonic-clonic seizures. She reported a previous history of seizures but had been seizure-free for 10 years. In addition, she reported a 20 year history of hand spasms and perioral paraesthesia. As part of the investigation for seizures while she was living in Poland 10 years ago, CT head had shown bilateral basal ganglia calcification and on this basis she had been diagnosed with Fahr...