Endocrine Abstracts

55-year-old man referred to the medical assessment unit by GP with weight loss and tachycardia. His past medical history was significant for myocarditis, long-QT syndrome, out of hospital cardiac arrest and an in-situ ICD. On examination the patient was tremulous, sweaty and tachycardic but otherwise well. An ECG demonstrated sinus tachycardia and routine blood tests were unremarkable. A clinical diagnosis of thyrotoxicosis was made and confirmed biochemically with TSH<0.0...

Leydig cell tumors are a rare form of hormonally active testicular tumors. They often present as a painless testicular mass. Infertility as the primary presentation is rare in this condition. A 32 year old man, presented with symptoms of infertility and hypogonadism which had occurred over a period of 1 year. He however was found to have a raised testosterone and estradiol levels as well as suppressed gonadotrophin levels. The patient had a historic sperm analysis done 2 years...

The four major hypertensive disorders in pregnancy are preeclampsia/eclampsia/HELLP syndrome, gestational hypertension, chronic hypertension and pre-eclampsia superimposed on chronic hypertension. The prevalence of hypertension in pregnancy has been reported to be around 6%. The commonest aetiology was found to be gestational hypertension which made up 40% of all cases. To our knowledge, secondary causes of hypertension in pregnancy has never been well described. We present a ...

Hemoglobin A1c (HbA1c) is formed from the addition of a glucose residue to the N terminus of the Beta chain of a hemoglobin molecule via a non-enzymatic glycation pathway. Its levels correlate with the ambient plasma glucose concentration. The 120-day life span of red blood cells makes HbA1c a useful tool to approximate the diabetic control of patients over three to four months. It has also been found to be an accurate predictor of the microvascular and macrovascular complicat...

Research in recent years has shown that biochemically euthyroid levels of thyrotropin (TSH) and serum free thyroxine (FT4) as determined by laboratories may not necessarily equate to clinical well-being of patients. The defined normal range of TSH and FT4 are wide and may differ from patients’ optimal range of TSH and FT4. We have previously described a deterministic mathematical model that can predict each patient’s unique homeostatic set point, which gives the opti...

Introduction: We present a rare case of squamous cell carcinoma of the sphenoid sinus presenting as a sellar mass and panhypopituitarism.Case presentation: A 60-year-old Chinese male with schizophrenia and a 20 pack year smoking history, was admitted to our hospital with headache and diplopia without visual field loss. Brain imaging with computed tomography (CT) and magnetic resonance imaging (MRI) revealed a 2.9 cm sellar mass based in the sphenoid sinu...

Introduction: Adefovir, commonly used for the treatment of hepatitis B, has dose-related nephrotoxicity, especially at doses of 60 mg daily and above. We describe a patient with Fanconi’s syndrome after being on low dose adefovir for more than 5 years.Case report: A 62-year-old Chinese man, a chronic carrier of Hepatitis B on adefovir 10 mg daily for over 5 years, presented with the incidental finding of profound yet asymptomatic hypokalemia (K 1.9 ...

We report a case surviving hyperparathyroid crisis, with the second highest serum calcium concentration ever reported.A 45-year-old female with type 2 diabetes and mixed hyperlipidaemia was admitted with extreme lethargy, dehydration and drowsiness. Serum corrected calcium was 6.49 mmol/l (2.2–2.6 mmol/l), phosphate 1.79 mmol/l, intact parathyroid hormone (PTH) 1059 pg/ml (15–65 pg/ml), creatinine 124 μmol/l and urea 16.0 mmol/l.<p cla...

TSH-secreting pituitary adenomas (TSHomas) are rare. Previously, the reported prevalence was one case per million populations although this is probably an underestimate. A recently published study reported a prevalence of TSHomas in Sweden of 2.8/million inhabitants.Methods/design: Observational study conducted in four tertiary referral centres in Ireland. We retrospectively collected data on the prevalence, demographics, hormonal profile, tumour charact...

Acromegaly is a rare condition resulting from excess secretion of GH and IGF1. Acromegaly is frequently associated with subfertility. As such there is little data on the course of the disease during pregnancy, and of the effects of the disease and its treatments on the foetus.Objective: We describe known pregnancies in women with acromegaly within the Republic of Ireland over a 15-year period.Methods: We collected clinical, biochem...