Endocrine Abstracts

Case history: A 39 year old female presented reporting a 5-year history of swollen face, hands and feet, with associated joint pain. She was initially investigated for rheumatoid arthritis. She had no significant past medical history except for a previous miscarriage in 2014 and treatment for hypertension in a subsequent successful pregnancy. Post-partum she breastfed with no difficulty for 18-months but remained amenorrhoeic during this time. During 2016 she noticed increase ...

Succinate dehydrogenase (SDH) mitochondrial enzyme complex mutations are associated with hereditary paragangliomas and phaeochromocytomas. Of late, there has been more awareness of the development of other tumours in this patient cohort. There is limited evidence of propensity for development of Prolactinomas and other pituitary tumours in patients harbouring mutations in the SDH complex genes. We present three cases attending our center with a diagnosis of prolactinoma and <e...

Introduction: Vaccine-induced thrombosis and thrombocytopenia (VITT) after vaccination against SARS-CoV-2 with the adenoviral vector-based vaccines ChAdOx1 and Ad26.COV2.S has been associated with adrenal pathology, such as bilateral adrenal vein thrombosis, adrenal cortex haemorrhage and adrenal insufficiency in six percent of patients1.Case report: We report the case of a 23-year-old healthy woman who presented at eight days after ChAdOx1 va...

Case History: We report the case of a 23-year-old woman who developed adrenal insufficiency secondary to bilateral adrenal haemorrhage in the context of vaccine-induced thrombosis and thrombocytopenia (VITT). She presented with breathlessness and chest pain eight days after receiving her first dose of the adenoviral vector-based ChAdOx1 vaccine. Over the course of a week, she developed fulminant VITT. Her only comorbidity was obesity, with BMI of 35 kg/m2. <p class="abstex...

History: We present the case of a 47-year-old man with heart failure (HF) and cranial diabetes insipidus (CDI) secondary to Langerhans-cell-histiocytosis. In the context of worsening HF with increasing shortness of breath and fluid retention, careful desmopressin dose reduction provided adequate aquaresis to restore euvolemia, obviating the need for usual diuretic treatments.Investigations: Echocardiography and a cardiac MRI revealed a non-dilated but se...

Case history: This 32-year-old lady was found to have a 23 × 17 mm bladder mass incidentally identified on a first trimester scan and confirmed with renal tract ultrasound. Urine collections showed mildly raised normetadrenaline 4.32 umol/24 h (normal range 0–3.0), plasma normetanephrine 1339 pmol/l (120–1180), no metastases were identified on MRI and genetic screening was negative. The patient had two previous normal pregnancies and deliveries. BP in the curren...

A 35 year old woman was referred to Endocrinology after imaging investigating unexplained pyrexia demonstrated an absent uterus. She was of Pakistani origin and was born phenotypically female with reported normal female genitalia. During late teenage years she experienced virilisation with deepening voice, increased pubic and axillary hair and clitoromegaly. She had absent breast development. Her parents were first cousins and siblings were unaffected. Investigations in Pakist...

We present a rare case of acute falciparum malaria complicated by hypocalcaemia while having normal renal function.Case: A 64 year old African lady presented with a 2 week history of lethargy, weakness and oliguria. She had returned from Malawi a fortnight previously and had not taken antimalarial prophylaxis. Her malaria screen was positive for Plasmodium falciparum and she was commenced on quinine. On day 5 of her admission she developed perioral pares...

There is growing recognition within Endocrinology physician and patient groups of morbidity and mortality in association with prescribing errors and dysnatraemia, in hospitalised patients with cranial diabetes insipidus (CDI). The study had two aims; firstly, to assess outcomes in hospitalised patients (paediatric and adult) with CDI by review of electronic records from 2012-2021, and secondly, to assess the same patient cohort’s perceptions of their care via telephone qu...

Rapid diagnosis and treatment of Cushing’s syndrome (CS) is essential for good outcomes. Current standards for appropriate timelines for referral are under review by NHSE. Data are required to substantiate standard setting. Knowledge of current referral pathways/processes are required to explore delays in accessing definitive surgical treatment. An audit of referral processes at Queen Elizabeth Hospital Birmingham was undertaken and further expanded to 4 additional tertia...