Endocrine Abstracts

A 73-year-old lady with a history of type two diabetes since 1993, mastectomy for carcinoma left breast in 2000, primary hypothyroidism, and hypertension was referred to the local hospital in view of poor glycaemic control in July 2001. Her medications included Thyroxine, Atenolol, and Tamoxifen, Frusemide, Gliclazide 160 mg BD and Pioglitazone 30 mg. At the time of referral her weight was 68.5 kg, (BMI 23.7), HbA1c 10.2%. She was started on Humalog mix 25 BD. In 2003 her weig...

Resistance to thyroid hormone is a dominantly inherited condition of impaired tissue responsiveness to the action of thyroid hormone. Thyroid hormone levels are elevated with failure to suppress TSH.The presentation is highly variable. In individuals with generalized resistance to thyroid hormone (GRTH) appear to have eumetabolic state with compensatory high thyroid hormone levels. In contrast, those who appear to have hyper metabolic features but may have similar thyroid horm...

Background: The use of opioids in non-cancer patients has increased dramatically over the past few years. The most common endocrine dysfunction with opioid use is hypogonadism, but it has been reported in a small number of cases that adrenal insufficiency and adult growth hormone deficiency can also occur.Clinical case: A 39 year old male presented with general fatigue, loss of libido and sweating for about six mont...

Background: The use of opioids in non-cancer patients has increased dramatically over the past few years. The most common endocrine dysfunction with opioid use is hypogonadism, but it has been reported in a small number of cases that adrenal insufficiency and adult growth hormone deficiency can also occur.Clinical case: A 39 year old male presented with general fatigue, loss of libido and sweating for about six mont...

Introduction: Despite the commonality of hyponatraemia in everyday clinical medicine it is often a poorly management condition in acute medical patients. A European guideline for diagnosis and management was published in 2014 to address such problems.Aims: To assess the standard of management of patients with hyponatraemia admitted to the medical departments in a rural District General Hospital. To improve investigation, diagnosis, and management of thes...

A 44-year-old gentleman presented to the Emergency Department with a 2-week history of fevers and rigors. Past medical history was unremarkable other than an earlier diagnosis of hypertension. He was noted to have new onset atrial fibrillation with rapid ventricular response, and a new diagnosis of hypertrophic obstructive cardiomyopathy (HOCM) was made on echocardiography. In addition, a vegetation was identified on the mitral valve. Treatment for infective endocarditis (Stre...

Case history: A 44-year-old gentleman presented to A&E with a 2-week history of fevers and rigors. He gave a background history of hypertension. He was noted to have new onset atrial fibrillation with rapid ventricular response, and a new diagnosis of hypertrophic obstructive cardiomyopathy (HOCM) was made on echocardiography. A vegetation identified on the mitral valve led to an unexpected diagnosis of infective endocarditis. Antibiotic treatment for infective endocarditi...

A 54-year-old man with a recurrent non-functioning pituitary gonadotroph adenoma previously treated with transphenoidal surgery (TSS) in 2015, presented to Charing Cross hospital for repeat transsphenoidal surgery in May 2022. Since his initial surgery, he remained on Levothyroxine 50 μg once daily only. There was no evidence of adrenal insufficiency (0900 h cortisol 333 nmol/l at day 6 following initial TSS). In February 2022, his electrolytes, FSH, LH, testosterone, pro...

Introduction: Unilateral adrenalectomy is an effective treatment for aldosterone producing adenoma. However, after adrenalectomy, suppression of the contralateral zona glomerolura (ZG) function can lead to transient hypotension & hyperkalaemia. We present a protracted case of post-operative adrenalectomy related hypoaldosteronism.Case: A 54-year-old hypertensive male with confirmed primary hyperaldoseronism (PRA<0.1 nm/h, aldosterone 1050 pmol/l;...

Androgen deficiency may contribute to sexual dysfunction in hypoadrenalism but its role in normal female physiology is uncertain. The aim of this study was to determine the role of androgens in the aetiology of sexual dysfunction in healthy women. Twenty-nine premenopausal women with loss of libido (subjects) and 13 healthy females (controls) were studied. They were aged 18 to 45 years and in a stable heterosexual relationship. Venous blood was taken at 9 am in the follicular ...