Endocrine Abstracts

Background: A 23-year-old woman diagnosed with Dunnigan-type familial partial lipodystrophy (FPLD) attended the joint Antenatal/Endocrine Clinic at 13 weeks of gestation. She was diagnosed at age 7 and subsequently developed type 2 diabetes at age 11 years. She was managed initially with metformin followed by addition of insulin. It was an unplanned pregnancy and her booking HbA1c was 8.4% (IFCC 68 mmol/mol).Prior to pregnancy, she was on a basal bolus r...

Case history: A 60-year-old male underwent left sided orchidectomy for a Seminoma in November 2005. As a part of work up for the Seminoma, he was noted to have bilateral adrenal masses which raised the possibility of metastasis.Investigations: CT scan of the abdomen showed 22 mm mass on the right with a Hounsfield units of −31 and a 12 mm mass on the left with Hounsfield units of −1. The radiological phenotype of these masses along with densi...

A 74 year old lady presently to casualty with generalized ill health, vomiting and a mechanical fall. She was well known to the psychiatry team with severe depressive disorder managed with Lithium. Clinical examination was unremarkable. Baseline blood tests confirmed hyperparathyroidism with corrected calcium of 3.24 mmol/l and high parathyroid hormone levels of 13.4 pmol/L. Lithium levels were normal. She improved clinically with intravenous hydration followed by pamidronate ...

A 60 years old man was referred to the ENT department with a three week history of swelling in the left parotid gland region. Examination revealed a firm mass involving the left parotid gland. Fine needle aspiration cytology of the mass raised the suspicion of a malignancy. MRI scan of head and neck was consistent with metastatic involvement of the ipsilateral lymph glands. He underwent left radical neck dissection and left parotidectomy. Histology confirmed adenocarcinoma of ...

A 52 year old man presented 5 years ago with a history of persistent rhinorrhea, blocked nose and epistaxis. MR scanning revealed blockage of the ethmoid sinus with polypoidal material extending into the nasopharynx, anterior cranial fossa and right orbit. He had craniofacial resection of the lesion and histology confirmed an olfactory neuroblastoma.He represented in 2005 with a two-week history of generalized weakness, lack of energy, and bilateral ankl...

Introduction: Primary hyperparathyroidism (PPTH) is a common referral to endocrine clinics with a clinical spectrum ranging from an asymptomatic state to a symptomatic disorder with or without end organ damage. We audited our management against the NIH guidelines which are endorsed by the Endocrine Society.Methods: There is no outpatient coding system to correctly identify all patients with primary hyperparathyroidism. We included patient on radiology da...

Introduction: We report a patient with hypercalcaemia secondary to parathyroid hormone related peptide (PTHrp) from metastatic oesophageal cancer and co-existing primary hyperparathyroidism.Case report: A 52-year-old lady was admitted to the hospital with a 2-week history of right scapula pain, reduced appetite and weight loss.Blood test revealed an adjusted calcium of 3.99 nmol/l (NR 2.1–2.55 nmol/l), PTH of 147 ng/l (NR 15&#...

We present two thyroid antibody positive euthyroid women with history of recurrent miscarriage who had successful pregnancy outcome when treated with levothyroxine.A 31-year-old Caucasian lady was referred to our endocrine services with a history of three previous miscarriages. She had strongly positive thyroid peroxidise antibodies (TPO) with normal thyroid function tests.We commenced her on 25 μg of levothyroxine. Within two...

We report a 41 yr old man who was found dead in his bed with a continuous glucose monitoring device in situ. He had type 1 diabetes diagnosed at age 14 years. He had poor glycaemic control during his teenage years and suffered from severe hypoglycaemic episodes and reduced hypoglycaemic awareness resulting in three road traffic accidents. His diabetes was complicated by proliferative retinopathy, nephropathy and peripheral neuropathy. He began continuous subcutaneous insulin p...

A 38 year lady was referred with a five month history of secondary amenorrhea, galactorrhoea, failure to conceive and elevated prolactin levels of 2023 miu/L (reference 102–496 miu/L). She could not undertake an MRI scan of the pituitary gland as she was claustrophobic and hence a CT scan was performed which did not show and gross pituitary lesion. Microprolactinoma was diagnosed and she commenced bromocriptine. She had normal white blood cells and neutrophil count prior ...