Endocrine Abstracts

A 34-year-old lady presented with irregular periods but no galactorrhoea. A prolactin level was 1326 mU/l.Clinical examination-Normal. BMI 26 and visual fields were full to confrontation. MRI scan of pituitary was reported as large pituitary macroadenoma measuring 11× 11× 12 mm denting the optic chiasm. Results of other endocrine tests were as follows; cortisol 265 nmol/l, TSH 0.32 mU/l, FT4 8.5 pmol/l, FSH 4 U/l, LH 1.6 U/l, oestradiol 104 pmol/l, GH 8.4 mU/l, IGF1 ...

We present a case of a 79 year old gentleman who attended the emergency department with a one day history of acute confusion and hallucinations. His background included trans-sphenoidal surgery for a gonadotrophic pituitary macro-adenoma in 2012 with subsequent panhypopituitarism and post-operative diabetes insipidus. He also had a history of restless-leg-syndrome for which he took Amitriptyline chronically, COPD and tablet-controlled diabetes mellitus. Of significant note, th...

A 64 year old female with a background history of hypertension resistant to dual therapy had recurrent admissions to the local emergency department with pulmonary oedema and chest tightness over the preceding 3 months associated with fluctuations in Troponin I levels. This led to multiple cardiac investigations including invasive coronary angiogram which did not report any abnormality. Her blood pressure was elevated at 200/120 mmHg and an electrocardiogram demonstrated sinus ...

An 87-year-old lady was admitted to hospital with severe unexplained hypoglycaemia with capillary glucose of 1.8 mmol/l and went on develop recurrent episodes of symptomatic hypoglycaemia during this admission. She had a background history of diabetes mellitus, well under controlled with diet and a previous diagnosis of solitary fibrous pleural tumour of left lung, which was resected completely in 2013 but reoccurred in 2022 with left sided pleural effusion. Her liver and rena...

An 87-year-old lady was admitted to hospital with severe unexplained hypoglycaemia with capillary glucose of 1.8 mmol/l and went on develop recurrent episodes of symptomatic hypoglycaemia during this admission. She had a background history of diabetes mellitus, well under controlled with diet and a previous diagnosis of solitary fibrous pleural tumour of left lung, which was resected completely in 2013 but reoccurred in 2022 with left sided pleural effusion. Her liver and rena...

A 53-year-old gentleman was seen following a recent diagnosis of type 2 diabetes in May 2009. He had suffered a subarachnoid haemorrhage in 1993 and remained under the local tertiary centre after developing secondary hypogonadism treated with testosterone replacement. The cause had never been established.The patient had previously been diagnosed with seronegative HLA B27 arthropathy and in December 2008 was admitted with acute cardiac failure and atrial ...

Diabetes is the leading cause of end stage renal failure. So, identifying patients at risk and intensifying management of blood pressure, lipids and glycaemic control can reduce and delay progression to organ replacement therapy. The aim of our study was to determine whether our pilot 3 monthly joint diabetes-renal clinics set up in April 2018 was able to achieve targets outlined by national guidelines and whether patient satisfaction and improved outcomes could lead to furthe...

Background: Empty Sella syndrome (ESS) is caused by the herniation of the subarachnoid space into the sella turcica, causing compression of the pituitary gland. Patients may be asymptomatic or exhibit different degrees of pituitary hormone deficiency. Pan-hypopituitarism can occur if there is decreased or absent secretion of all of the anterior pituitary hormones. Case: We report the case of a 68 year old female of Pakistani background who was visiting t...

Isolated Central Diabetes Insipidus is a rare condition characterised by deficiency of arginine vasopressin (AVP) which presents with polyuria and polydipsia. The reported prevalence of diabetes insipidus is 1 in 25,000. The pathogenesis of central diabetes insipidus is often uncertain however the known causes can be divided into acquired, through trauma or vascular injury as well as infiltrative including malignancy, and congenital abnormalities which accounts for less than 1...

Case History: A 20-year-old lady was referred by GP to the endocrine clinic with frequent and gradually worsening non-specific headaches and primary amenorrhoea. She denied cyclical pelvic pain, acne, hirsutism or anosmia. She consulted her GP for delay in menarche when she was 16 years old but was advised to wait until the age of 18 years but unfortunately it was the middle of the Covid-19 pandemic and hence the delay in the referral. There was past medical history of migrain...