Endocrine Abstracts

25-years-old lady presented to gastroenterologist with recurrent bouts of vomiting associated with abdominal pains, fatigue, muscle aches and dark tan. Initial biochemical profile and upper GI endoscopy were normal. On examination she had dark pigmentation of the palms well hydrated and haemodynamically stable. No family history of autoimmune conditions. She had traumatic laceration of the liver as a child, otherwise no significant past medical history.A...

Introduction: Empty sella syndrome is a condition in which sella turcica is partially or completely filled with CSF resulting in a displacement of normal pituitary gland. Primary empty sella is due to inherent weakness of diaphragm sella or to an increase in intracranial pressure which promotes herniation of arachnoid membranes in to pituitary fossa. More common in middle aged obese female and headache is the most common presenting symptom. It may be associated with one or mor...

A 33 year-old male bus driver with long standing pemphigus requiring high dose prednisolone, presented with acromegaly in 2001. MRI pituitary revealed a 2×2×0.5 cm pituitary adenoma and his GH levels of 14.8–16.4 nmo/L throughout and were not suppressible with glucose. His IGF1 was 191 nmol/l (normal range: 13–64 nmol/L), Prolactin 6,557 milliunit/L, testosterone 2 nmol/L and cortisol uninterpretable as he was on prednisolone. Trans-sphenoidal hypophysectom...

Germline mutations in the succinate dehydrogenase subunit-B gene (SDHB) are well recognised for predisposing to head and neck paraganglioma, sympathetic paraganglioma, phaeochromocytoma and renal cell carcinoma. The co-existence with pituitary adenomas remains uncommon.We report a 31-year-old female who presented at age 29 years old with 9 months of secondary amenorrhoea. Prolactin was 3000 mIU/l and a 1.7-cm macroprolactinoma revealed on MR pituitary. T...

DIPNECH is pre-invasive precursor to carcinoid tumors and tmorlets, most of which present with pulmonary symptoms. We present a case of ectopic cyclical ACTH producing DIPNECH.33-year lady presented with a short history of weight gain, abdominal striae, proximal myopathy and secondary amenorrhoea. She reported a previous episode with similar symptoms one year earlier which resolved spontaneously after a few weeks. Random cortisol 4000 nmol/l, ACTH 98 ng/...

Introduction: Typically, patients with a microprolactinoma will have serum prolactin level between 2,000-4,000mIU/l. The primary goal of treatment is to normalise prolactin level and thereby improve symptoms associated with a raised prolactin. Dopamine (D2) agonists are the main stay of treatment with some patients unable to tolerate dopamine agonists rather than being resistant to the medication.Case report: A 26-year-old lady with a history of anxiety ...

Background: Incidence of non-functioning pituitary macroadenoma (NFPMA) is very rare in pregnancy. We describe a case of complicated non-functioning pituitary macroadenoma presented during pregnancy. 26 year old female at 21 weeks gestation presented to emergency services with worsening headaches, nausea and vomiting for 2-3 months. This was associated with transient double vision and confusion since 2 days. She was admitted to emergency department 3 weeks ago with vomiting an...

Background: Pituitary metastasis (PM) is a rare occurrence in malignancy, associated with poor prognosis. Only 7% of patients are symptomatic. High index of suspicion and prompt investigation are essential. We report a case of PM, highlighting challenges in diagnosis and management.Case Report: Sixty-six year old male was referred to endocrinology due to headaches and hyponatremia. He had metastatic colorectal carcinoma, treated with bowel, liver and lun...

Introduction: Non-Hodgkin lymphoma (NHL) involving the hypothalamus and pituitary gland is rare. Central nervous system involvement by NHL may be either as a primary tumour or from systemic lymphoma. We report an interesting case of aggressive central nervous system (CNS) lymphoma presenting as pituitary macroadenoma.Case report: A 67-year-old Caucasian woman presented with sudden onset of left eye ptosis and diplopia. Examination showed left third nerve...

Background: Diabetes Insipidus (DI) is uncommon during pregnancy. It may predate pregnancy, be unmasked by pregnancy or arise de novo during pregnancy secondary to other pathology. We present a case of DI in pregnancy to highlight challenges in management.Case Report: A 27-year-old lady at 21 weeks’ gestation, presented to A&E with worsening headache and confusion for three to five months. She was hemodynamically stable, had bitemporal hemianopi...