Endocrine Abstracts

ObjectiveTo report and discuss a kindred with pathological hyperprolactinaemia.Case 1 (Proband)A 39-year old man presented in June 2003 with 3-years of erectile dysfunction (ED) and was found to have hyperprolactinaemic hypogonadotrophic hypogonadism: LH 1.0 & FSH 1.5 U/L, Testosterone 5.8 nmol/L, PRL 4154 mU/L. Pituitary function was otherwise normal. MRI demonstrated an intrasellar macroadenoma. Cabergo...

INTRODUCTION: Hyperprolactinaemia frequently causes secondary hypogonadism through central suppression of gonadotropin secretion. Macroprolactinomas (>1cm diameter) may additionally cause more generalised hypopituitarism; a recent series finding the prevalence of TSH and ACTH deficiencies to be 35% and 9%, respectively. Recovery of the thyrotropic and/or corticotropic axes is well described following surgery to pituitary tumours, but remains poorly defined in relation to me...

We present a case of acquired hypogonadotrophic hypogonadism (HH) in a 54-year-old man that illustrates the need for wider endocrine screening in such patients. Having undergone complete pubertal development as a teenager and subsequently fathered two children, the patient presented with a nine-month history of reduced libido, erectile dysfunction, hot sweats and headaches. His GP had diagnosed HH on the basis of a low testosterone with inappropriately low gonadotrophins. Exam...

Objective: To determine whether there is a seasonal variation in bone mineral density (BMD) related to exposure to sunlight.Design: A single-centre retrospective analysis of BMD measurements.Participants: Of 10 971 patients who had undergone bone densitometry in the period 2000–2007. 7513 were female and 3458 male.Results: Anonymised data on BMD of lumbar spine was gathered from existing hospital databas...

Nebido (testosterone undecanoate 1000 mg injection) was used to induce pubertal development in 2 apubertal men with Kallmann’s syndrome, in their 6th decade.Case 1: Originally diagnosed with Kallmann’s syndrome aged 21, but then discontinued treatment for the next 25 years. Now aged 50, he was markedly eunuchoid: G3-4, P3, A1.Investigations: Testosterone 1.0 nmol/l, LH and FSH <0.5IU/l.Normal fe...

Since the observation in 1961, that phenytoin treatment caused a reduction in protein bound iodine, the effect of various anticonvulsants on the thyroid hormones and in causing sub clinical and overt hypothyroidism has been a matter of debate. There are no reports linking newer antiepileptics like lamotrignine to thyroid hormone abnormalities. We report three patients who developed overt hypothyroidism while on treatment with Primidone, Lamotrignine and Carbamazepine respectiv...

AimsTo define the prevalence of hyponatraemia (serum sodium <135 mmol/l) on our medical admissions unit and review the laboratory investigations, diagnosis and management of patients with critical or severe hyponatraemia (serum sodium <120 mmol/l).MethodsSerum sodium levels requested from the medical admissions unit over a six-month period were retrospectively collated. Case notes and biochemistry dat...

Clinical case: A 37 year-old Caucasian man was admitted with sudden onset lower limb weakness following a carbohydrate-heavy meal the night before. Pulse was 110/min, sinus rhythm, BP 167/92 mmHg. There was generalised muscle weakness, particularly in his legs, with hyporeflexia and hypotonia. There was no sensory deficit and plantar responses were downgoing. Serum K+ was 2.4 mmol/L, associated with typical ECG anomalies, and was corrected with 40 mmol intravenous KCl followed...

Clinical CaseA 19-year old ethnic Pakistani presented with severe, longstanding hirsutes without virilisation. Menarche had occurred at age 14, following which she had experienced 4-6 periods a year. She had always been “underweight” by UK/WHO criteria and, given a BMI of 16.5 kg.m−2, there were concerns about hypothalamic oligomenorrhoea.InvestigationsFasting glucose 5.5 mmol/L &#...

Polycystic ovarian syndrome (PCOS) is the commonest cause of hyperandrogenism in women. Severe hyperandrogenism or virilisation, however, suggest the need to consider rarer causes e.g. Cushing's, congenital adrenal hyperplasia and androgen-secreting tumours. Here we present a case of PCOS where the remarkable response of severe hyperandrogenism with polycythaemia to metformin excluded these rarer causes without the need for complex or invasive investigation.<p class="abste...