Endocrine Abstracts

A 43-year-old, previously well Asian male was found to have a large intrasellar mass when investigated with an MRI brain for a history of reduced hearing. He had no other clinical history. His visual fields were normal. The tumour had extended to the suprasellar cistern but there was no optic nerve compression. Pre-operative biochemistry showed mild panhypopituitarism with a 0900 a.m. cortisol of 135 mmols/l, a free T4 of 8.5 pmols/l, a free T3 of 3.2 pmo...

Incidentally discovered adrenal masses on abdominal imaging for unrelated reasons have a prevalence of 1-7%. A great majority of these are non-functioning adenomas, but 5-30% are associated with autonomous cortisol secretion (ACS), which is mainly subclinical, and 1-5% with phaeochromocytoma or Conn’s syndrome. Here we report two cases of overt functioning adrenal adenoma with coexisting ACS. We could not find any other reports of such cases in the literature.<p class...

Subacute thyroiditis (SAT) is a self-limited inflammatory condition of the thyroid characterised by a clinical course of hyperthyroidism, hypothyroidism, and then return to normal thyroid function. The inflammation is thought to be triggered by a viral infection and is usually treated with anti-inflammatory medications and steroids. Recurrences can uncommonly occur and could be difficult to manage. There are some promising reports of the role of Colchicine in managing recurren...

We present a case of a middle-aged lady with clinical features suspicious of Addisons, however an initial false negative short synacthen test (SST), resulted in delay of diagnosis.Case: A 62-year-old lady presented to ED with a month history of generalised malaise, weakness, dizziness and vomiting. She had a background of type2 diabetes mellitus, previous left parathyroidectomy for primary hyperparathyroidism and B-thalassaemia trait. Admission bloods in...

We present a case of a middle-aged lady with clinical features suspicious of Addisons, however an initial false negative short synacthen test (SST), resulted in delay of diagnosis.Case: A 62-year-old lady presented to ED with a month history of generalised malaise, weakness, dizziness and vomiting. She had a background of type2 diabetes mellitus, previous left parathyroidectomy for primary hyperparathyroidism and B-thalassaemia trait. Admission bloods in...

Case History: A 70-year-old man of Chinese origin presents with a two-month history of worsening visual acuity and double vision. He denied systemic symptoms apart from marginal weight loss. Other medical history includes stable asthma, treated with inhalers. He has a niece and nephew with thyroid disease. He is an ex-smoker, retired accountant, and drinks occasional alcohol. On examination, he was normotensive with a body mass index of 22 kg/m2 however was found to...

We report the case of an 82-year-old lady who was admitted with hypercalaemic crisis (adjusted Calcium 4.82 mmol/L) and acute kidney injury (creatinine 169 micromol/L). PTH was 295 pmol/L, raising the suspicion of an underlying parathyroid carcinoma. She had no palpable neck mass. Her ALP was 131 IU/L and Vitamin D 73 nmol/L; myeloma screen was negative and chest radiograph showed no pathology. A DEXA scan revealed osteoporosis. The hypercalcaemic crisis...

We report the case of an 82-year-old lady who was admitted with hypercalaemic crisis (adjusted Calcium 4.82 mmol/L) and acute kidney injury (creatinine 169 micromol/L). PTH was 295 pmol/L, raising the suspicion of an underlying parathyroid carcinoma. She had no palpable neck mass. Her ALP was 131 IU/L and Vitamin D 73 nmol/L; myeloma screen was negative and chest radiograph showed no pathology. A DEXA scan revealed osteoporosis. The hypercalcaemic crisis...

We report a case of a 20-year-old male with a clinical profile of Gorlin-Goltz syndrome with delayed puberty. This 20-year-old man had learning disablitiy, macrocephaly and multiple jaw cysts. His other clinical features included agenesis of the carpus callosum, obesity and multiple cutaneous lesions suggestive of angiolipomata. His pubertal development was delayed although a LHRH test done at the age of 16 showed a normal response. Radiological features included macrocephaly,...

A 49-year-old female was admitted to medical HDU with diabetes ketoacidosis (DKA) and newly diagnosed diabetes. Six months previously she was diagnosed with malignant hypertension. She had poorly controlled blood pressure despite treatment with four anti-hypertensives, which were her only regular medication. She had never used any medications or creams containing glucocorticoids. She had no history of hypokalaemia and reported no use of liquorice. She recently attended an outp...