Endocrine Abstracts

47 year old gentleman referred to Neurosurgery Department with incidental findings of pituitary macroadenoma with chiasmal compression and cavernous sinus involvement, whilst getting investigated for tinnitus. His past medical history included chronic migraines only. He has been experiencing increased frequency of migraines along with lethargy, decreased libido and loss of morning erections for some time prior to presentation. His formal visual fields showed a slight inferior ...

26 year old gentleman with classic salt-wasting CAH due to 21-hydroxylase deficiency was maintained on hydrocortisone 7.5mg+7.5mg+5mg along with fludrocortisone 100 mg OD. Due to inadequate biochemical control, his hydrocortisone was increased to 10mg+10mg+5mg initially, which was subsequently switched to prednisolone 5mg+2.5mg. His 17-OH progesterone continued to remain high (300-400 nmol/l) with suppressed gonadotrophins and a high normal testosterone suggestive of mostly ad...

Introduction: Primary parathyroid carcinoma accounts for less than 1% of the parathyroid gland tumours and almost always presents as primary hyperparathyroidism. Very few Turner syndrome patients have been reported so far to present with primary hyperparathyroidism secondary to parathyroid adenoma. We report a case of parathyroid carcinoma in a 59 years old lady with Turner syndrome who is presenting with recurrent mild hypercalcemia.Case presentation: A...

Case history: A 38 years old Afro-Caribbean gentleman presented in June 2018 with symptoms of hyperthyroidism. He is a smoker and takes alcohol occasionally. Examination revealed fine tremors, tachycardia, moderate sized goitre with no thyroid bruit and right sided proptosis. Thyroid workup revealed suppressed TSH, raised free T4 and TRAb of 9.75 IU/L suggesting Graves’ Thyrotoxicosis. He was started on 20 mg of Carbimazole (CBZ)OD with Propanolol. After initiating carbim...

Introduction: Silent corticotroph adenomas(SCA) are defined as pituitary adenomas showing positive staining for adrenocorticotrophic hormone in immunohistochemical studies not associated with clinical/laboratory features of hypercortisolaemia. We report a case of SCA in a 61-year-old man, who presented with pituitary apoplexy.Case presentation: Patient presented with persistent diplopia of 3 months duration, associated with severe headache for 1 week. He...

Introduction: Long term treatment with corticosteroids has been widely used, due to the well documented immunosuppressive and anti-inflammatory activity. Corticosteroids are among the most widely prescribed drugs in oncology and post-transplant patients. However, long-term treatment with a dose of corticosteroids, which equals prednisolone 5mg/day for at least 4 weeks, is very likely to result in suppressed function of the hypothalamic pituitary adrenal (HPA) axis, a condition...

Case History: 38 year old male presented with thyrotoxic symptoms and exophthalmos with an initial Free T4 of > 100 pmol/l; TSH < 0.01 mIU/l and thyroid receptor antibody positivity. He had a platelet count of 72* 109 /L at presentation and was started on carbimazole. A month later he had platelet count of 9* 109 /L with normal white cell count and haemoglobin levels. He was switched to propylthiouracil, but was readmitted with platelet count of 1...

Objective: The project was designed to Assess And IMprove (AAIM) the practice of healthcare professionals (HCPs) around the corticosteroid sick-day rule, involved in caring for transplant and oncology patients requiring treatment with corticosteroids long-term.Introduction: Corticosteroids are widely prescribed drugs in oncology and post-transplant patients. Long-term treatment with corticosteroids dose, which equals pre...

Case history: 48-years old man, with no comorbidities, presented to A&E due to global headache of 20 days duration, with associated intermittent vomiting, but no photophobia, cranial nerve impairment, neck pain or visual disturbance. The first head-scan (CT, computed tomography) was unremarkable, hence was discharged with safety advises. One week later, he represented to A&E with similar complaints. On enquiries, he mentioned to be reviewed by an optician 6 months ago,...

Introduction: Pituitary metastasis (PM) is a rare condition and associated with a reduced life-span. The most common primary sites are breast and lung, followed by thyroid and renal cell carcinoma. Patients with PM are mostly asymptomatic and incidentally discovered during neuroimaging. Characteristic symptoms are reported in <20% and most commonly include visual involvement, diabetes insipidus, and panhypopituitarism. We here describe a case with malignant melanoma (MM) w...