Endocrine Abstracts

35-year-old lady, has a background of Hypertension, oophorectomies for ovarian cancer and previous 2 IVF attempts, referred to endocrinology with three-week history of blurred vision, bitemporal hemianopia and large pituitary mass on MRI Upon assessment, she reported visual disturbance and intermittent headache. She has no periods which is expected with the history of oophorectomy, but she denied galactorrhoea or any symptoms suggestive of pituitary hormone excess or deficienc...

Introduction: Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a rare cause of Cushing’s syndrome and is more often diagnosed as bilateral adrenal incidentalomas with subclinical cortisol production. It is mainly a heterogeneous disease, but familial cases have been reported. Treatment of PBMAH with overt Cushing’s syndrome is usually bilateral adrenalectomy with unilateral adrenalectomy occasionally used to normalize urinary free cortisol (UFC) in patie...

Introduction: Familial dysalbuminemic hyperthyroxinemia (FDH) is a familial autosomal dominant condition that was first reported in 1979. It is caused by a mutant albumin molecule with an increased affinity for serum thyroxine (T4), despite the serum albumin level being normal. FDH causes increase in total T4 and T3 level with normal TSH level. As FDH patients are clinically euthyroid and asymptomatic, they do not require treatment.Case report: 68-year-o...

Pituitary hyperplasia secondary to primary hypothyroidism (PHPH) is a consequence of long term untreated or uncontrolled primary hypothyroidism. The proliferation of thyrotrophs in the pituitary gland, due to the lack of negative feedback on the hypothalamus from low circulating thyroid hormone levels, causes elevated thyroid stimulating hormone (TSH) levels. Hyperprolactinaemia can also be present due to the stimulatory effect of TSH on lactotrophs. Pituitary hyperplasia caus...

Thyroid dysfunction by Immune Checkpoint Inhibitors (ICPI) is a common Immune-Related Adverse Event (IRAE). Thyroid dysfunction is prevalent in cancer patients receiving pembrolizumab treatment (ICPI). Most prevalent clinical manifestations are reversible destructive thyroiditis and overt hypothyroidism. Pembrolizumab-induced thyroid IRAE’s have been reported to range from 3.2% to 10.1%.Case report: This case reports a 64-year-old l...

Introduction: Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a highly heterogeneous disorder and is the cause of <2% of cases of Cushing’s syndrome. Around 20-25% of patients with primary bilateral macronodular adrenal hyperplasia (PBMAH) have a mutation in ARMC5.Case report: 47 year old gentleman was incidentally found to have bilateral adrenal lesions when he had a CT scan of his chest performed for chest and back pains. He had ...

Pseudohypoparathyroidism (PHP) is highly heterogeneous rare disorder characterized by end organ resistance to PTH action with proven genetic component. PHP-Ib classically refers to a condition characterized by renal resistance to PTH in the absence of other endocrine or physical abnormalities and in the presence of a normal GNAS alfa activity and only few cases have been reported so far. We report a case of 43 year old gentleman was diagnosed to have seizures at the age of 13 ...

Background: Thyroid stimulating receptor hormone receptor antibodies (TRAb) markers are useful in confirming diagnosis of Graves’ disease, but also recognised as a predictor of relapse. Good practice dictates that a TRAb is measured at the commencement of treatment, to confirm a diagnosis of graves’ disease. Repeating the TRAb before discontinuation of treatment can assist in guiding treatment. If TRAb remains elevated, the chances of relapse are inc...

Spindle cell oncocytoma (SCO) is a rare nonfunctioning neoplasm of the anterior pituitary gland .This tumour is often misdiagnosed as pituitary adenoma or pituitcytoma due to it’s location and symptoms. Such tumours are highly vascular radiologically and histologically. We report a 54 year old gentleman who was found to have pituitary adenoma on CT head performed after a fall. Subsequent Pituitary MRI showed 25×18 mm pituitary macroadenoma with optic chiasm compressi...

Background: The published data on the natural history of (presumed) non-functioning pituitary microadenomas (micro-NFAs) is possibly compromised by small sample sizes, short follow-up and inclusion of cases with other pathologies in the analyses.Objective: To clarify the long-term outcomes of micro-NFAs in a large cohort of patients.Methods: We conducted a multi-centre, retrospective, cohort study involving 22 UK endocrine departme...