Endocrine Abstracts

Case history: A 62-year-old lady with no significant past medical history presented early February 2021 with a week history of epigastric pain, tiredness and poor oral intake, 5 days following her first dose of AstraZeneca Covid-19 vaccine. She was cardiovascularly stable but generalised abdominal tenderness was noted. There was no history of hypertension, hypokalaemia or symptoms consistent with phaeochromocytoma.Investigations: Admission bloods reveale...

Cardiac phaeochromocytomas account for only 1% of all extra-adrenal phaeochromocytomas. We present a rare case, which through a multidisciplinary approach achieved an excellent outcome. A 49-year-old male presented with chest pain. Echocardiography revealed a pericardial mass behind the left atrium and subsequent cardiac angiography confirmed a highly vascular lesion, suspicious for a phaeochromocytoma. Urine and plasma metanephrines were elevated; urine normetadrenaline 10888...

A 44-year-old gentleman presented to the Emergency Department with a 2-week history of fevers and rigors. Past medical history was unremarkable other than an earlier diagnosis of hypertension. He was noted to have new onset atrial fibrillation with rapid ventricular response, and a new diagnosis of hypertrophic obstructive cardiomyopathy (HOCM) was made on echocardiography. In addition, a vegetation was identified on the mitral valve. Treatment for infective endocarditis (Stre...

Case history: A 44-year-old gentleman presented to A&E with a 2-week history of fevers and rigors. He gave a background history of hypertension. He was noted to have new onset atrial fibrillation with rapid ventricular response, and a new diagnosis of hypertrophic obstructive cardiomyopathy (HOCM) was made on echocardiography. A vegetation identified on the mitral valve led to an unexpected diagnosis of infective endocarditis. Antibiotic treatment for infective endocarditi...

Case history: An asymptomatic 26-year-old female was found to have hypercalcaemia with an associated normal PTH and vitamin D deficiency on blood tests in primary care. She was referred to the endocrinology clinic for further assessment. There was no history of renal calculi, constipation or fractures. The patient was taking the combined oral contraceptive pill only. There was a family history of hypercalcaemia, with an uncle affected in his 50s and a first cousin in his 20s. ...

Background: Prevalence of Addison’s disease (AD) among patients with Type 1 diabetes mellitus (T1DM) is estimated at 0.2%, whilst prevalence of T1DM among patients with AD can be up to 14%. Residual adrenal function in patients with established AD may be present in up to 30% of cases but its clinical significance is not fully clear.Aims: To evaluate the prevalence of AD with preserved glucocorticoid function in patients with T1DM at Newcastle Diabet...

Introduction: Pseudohypoparathyroidism (PHP) is a rare cause of hypocalcaemia due to parathyroid hormone (PTH) resistance in the proximal renal tubules. In contrast to PHP type 1A, PHP type 1B is characterised by the absence of the characteristic skeletal abnormalities and is transmitted in an autosomal dominant manner, but in the maternal line. Patients may have resistance to the action of other G-protein signaling hormones, like thyroid stimulating hormone (TSH).<p class...

A 48-year-old male presented with headache, cough and recurrent nose bleeds. Clinical examination showed saddle shape nose deformity. His past medical history included primary hypothyroidism diagnosed at the age of 10 years, was taking levothyroxine. His brother had a Rathke’s cleft cyst, surgically removed. His blood test were as follows: Sodium 125mmol/l, TSH 0.10mU/l, free T4 10.2pmol/l, freeT3 2.6pmol/l, cortisol < 28nmol/l, prolactin 240mU/l, FSH 1.8U/l, LH 0.3U/...

A 45-year-old female presented with secondary amenorrhea. Since menarche, her period has been irregular, which she initially managed with oral pills, which were discontinued in 2009. Subsequently, she does have complete secondary amenorrhoea. She has hirsutism at the age of 20. Which was initially well controlled with oral contraceptive pills but has been getting worse over the years. Ferriman-Gallwey’s score was high. She also stated that her weight had been steadily inc...

ACTH is a 39 amino acids polypeptide which stimulates adrenocortical steroid production. The N-terminal segment of ACTH(1–24) is biologically active and the C-terminal is considered to have greater antigenicity. In one previous (‘RoSA’) and one current (‘RADS2’) clinical trial synthetic ACTH (zinc tetracosactide; depot synacthen) was administered to autoimmune Addison’s disease (AAD) patients to stimulate adrenocortical regeneration. 4/13 RoSA pat...