Endocrine Abstracts

Case: A 74-year-old female presenting with central weight gain, proximal myopathy, thin skin and bruising. Clinical examination identified central obesity, round facies, dorso-cervical and supra-clavicular fat pads.Investigations: Bloods revealed hypokalaemia (3.2mmol/l), elevated cortisol levels (>1000nmol/l) persisted post low dose Dexamethasone suppression test, with a supressed ACTH (<5). Urine free cortisol 1842nmol/24hrs (0-165). CT Chest-A...

Introduction: Hyperparathyroidism in pregnancy is rare and is associated with significant maternal and fetal morbidity and mortality. Recognition can be challenging due to the inability to differentiate hypercalcaemia symptoms from those of pregnancy, studies suggest that up to 80% of cases may be undiagnosed. We report three cases of hyperparathyroidism in pregnancy at Royal Derby Hospital, investigations (Table 1) and management in these patients are reviewed.<p class="a...

Introduction: We describe the case of a patient referred to Cardiology with an abnormal ECG & hypertension. Investigation led to the diagnosis of catecholamine induced cardiomyopathy caused by a pheochromocytoma. The case is unique as the cardiomyopathy was reversed with alpha and beta blockade prior to surgery.Case: A 56 year old female with 20 pack year smoking history, no regular medications and evidence of hypertension underwent CT AP for abdomin...

Case: This 23-year-old lady initially presented in 2013 with headaches, galactorrhoea and secondary amenorrhoea. Visual fields were normal to confrontation. Prolactin levels were elevated at 3028miu/l. MRI pituitary revealed a 14x13x15mm adenoma pushing the pituitary stalk posteriorly, and compressing the left side of the optic chiasm.Initial Management: Cabergoline was commenced (250mg twice weekly), with good clinical ...

Background: Cranial diabetes insipidus (DI) is characterised by the inability to produce ADH (antidiuretic hormone) also known as AVP (arginine vasopressin) resulting in uncontrolled diuresis. Desmopressin is a synthetic form of AVP used to treat this. Treatment errors can lead to dehydration and hypernatremia which can be life-threatening. In view of recent literature suggesting current concerns with Desmopressin administration worldwide, Diabetes Insipidus i...

Introduction: The physiological actions of catecholamines have led to the empirical use of adrenaline in the management of anaphylaxis, with alpha-adrenergic activation increasing peripheral vascular resistance and beta-adrenergic activation relaxing bronchial smooth muscle and inhibiting histamine release. Supraphysiological levels of catecholamines are released by phaeochromocytoma and hence blockade of these same receptors is required for symptom control, prevention of end ...

Introduction: Incidental indeterminate adrenal nodules discovered on imaging in patients under the care of University Hospitals of Derby and Burton Foundation Trust are discussed in Urology MDT. MDT cases were reviewed for a 12 month period before an endocrinologist joined the MDT in January 2018 and 12 months afterwards, to review the compliance of local practice with European Society of Endocrinology (ESE) Guidelines for the management of adrenal incidentalomas.<p class=...

Case 1: A 57-year-old lady referred to the Endocrinology department due to a CT Abdomen, performed for abdominal pain, reporting the presence of an incidental left adrenal adenoma. Imaging was reviewed in the Adrenal MDT meeting and further CT Abdomen arranged. Images were reviewed before and after oral contrast. Pre-contrast images revealed a small volume of high-density material within a rounded structure in the left upper quadrant, immediately superior to t...

Introduction: Hydatid disease (Cystic echinococcosis) is a zoonotic parasitic infection with the Echinococcus granulosus tapeworm resulting in cyst(s) within viscera. The predominant site for cyst formation is the live, with primary adrenal cyst accounting for less than 0.5% of presentation. We report a case of primary adrenal hydatid disease.Case report: A 62 year old female presented to the hospital with history of rig...