Endocrine Abstracts

A 37 year old Afro-Caribbean woman, with panhypopituitarism secondary to a pituitary macroadenoma was referred from a DGH physician to the neurosurgeons. She complained of headaches and blurred vision. Initial presentation was with malaise, weight loss, vomiting, abdominal pain, and secondary amenorrhoea. She was found to have panhypopituitarism and was on thyroxine and hydrocortisone replacement therapy. Abdominal CT had showed widespread axillary para aortic and iliac lympha...

A 34-year-old female was seen in the joint diabetic antenatal clinic during her second pregnancy. She had a very unfortunate first pregnancy, which resulted in a still birth following a traumatic delivery. She also had a large post-partum haemorrhage causing Sheehan’s syndrome. Hormone replacement therapy had been commenced, including hydrocortisone, thyroxine and growth hormone (GH). Pre-treatment quality of life assessment in GH deficient adults score (Qol-AGHDA) 21, an...

A 38-year-old lady was referred to our endocrinology department with headache, elevated prolactin concentration and intolerance to cabergoline by the gynaecologist. She was found to have elevated prolactin whilst investigating for secondary amenorrhoea. She described her headaches to be worse on cough, sneezing and laughing. There was no evidence for raised intracranial pressure clinically and no visual field defect was identified. Prolactin was 3194 miu/l, however there was n...

Pituitary gland has an influence on erythropoiesis. Anaemia is thought to be due to loss of thyrotrophic and adrenotrophic hormones. Testosterone is also known to stimulate erythropoiesis. Here we present a patient with long standing iron deficiency anaemia, which corrected with management of hypopituitarism.A 72-year-old gentleman was under regular review at the diabetic clinic with type 2 diabetes mellitus. He had a background medical history of COPD, ...

Osteoporosis is a reduction in bone mass, with micro-architectural deterioration, leading to an increased risk of fragility fractures. A secondary cause for osteoporosis (caused by a specific well-defined clinical disorder) is found in a proportion of patients, which varies in different patient populations.We evaluated the utility of a 'standard panel' (FBC, PV, plasma protein electrophoresis & BJP, thyroid function tests, U&Es, calcium and bone ...

A 45 year old male was referred in November 2001 to the endocrine clinic with the complaints of sudden onset marked thirst, polyuria with nocturia (six times) for two months. His past medical history includes a diagnosis of solitary sacral plasmacytoma diagnosed in 1998, based on bone marrow aspirate and trephine in the presence of the paraproteinaemia. He was successfully treated with radiotherapy. There has been no history of head injury and has not been on regular medicatio...

Background: Hypercortisol states present a diagnostic conundrum. Other conditions such as cyclical and subclinical Cushings pose additional challenges. We report a complex clinical presentation of thymoma with coexisting subclinical Cushing’s.Case report: A 65-year-old man presented to chest clinic with breathlessness and anterior mediastinal mass on CXR. CT scan demonstrated a 7.5 cm probable thymoma and bilateral adrenal masses of varying sizes up...

A 24-year-old Asian lady with no past medical history was admitted under the surgical team with right sided abdominal pain, nausea and vomiting, postural dizziness and weight loss. She was give trimethoprim for a possible urinary tract infection along with paracetamol, tramadol and diclofenac. Blood tests on admission demonstrated normal renal, liver and thyroid function, a normal C-reactive protein and full blood count and a low sodium of 131 mmol/l. An abdominal ultrasound w...

Dumping syndrome is a common complication following gastric bypass surgery. Rapid gastric emptying in dumping syndrome triggers an inappropriate hyperinsulinaemic response which leads to hypoglycaemia. This can be very disabling and challenging to manage in clinical practice. Here we present a lady with dumping syndrome whose post meal hypoglycaemia improved with metformin.A 42-year-old female presented with eight months history of increasing mood swings...

Full replacement dose of thyroxine should not be administered initially to elderly hypothyroid patients, those with a history of coronary artery disease and to patients with long-standing severe hypothyroidism. Here, we present a 27-year-old lady with profound longstanding hypothyroidism, who developed cardiac failure on a small dose of thyroxine.She presented to her General Practitioner with longstanding symptoms of lethargy, poor concentration, constip...