Endocrine Abstracts

Immunotherapy targeting the CTLA-4 and PD-1pathways has revolutionised the treatment of several cancer types, and is under investigation in many others. However, its use is associated with a variety of side effects, many of which associated with immune system activation. In metastatic melanoma, the combination of ipilimumab (an anti-CTLA-4 antibody) and nivolumab (an anti-PD-1 antibody) has been shown to have greater efficacy than either drug as monotherapy, though as expected...

We present a case of recurrent troublesome hypothyroidism with three pathologies to vex her medical attendants. This 75 year old lady was treated for Grave’s thyrotoxicosis elsewhere when she was 55 years old. She had positive TSH receptor antibodies and high uniform uptake of radioactive iodine. She presented to us age 65 with relapsed thyrotoxicosis and was maintained on carbimazole 5 mg OD for 8 years which was then stopped. She had been off medication for 2 years when...

Opioids –Yet another Cause for Adrenal Insufficiency. Opioid prescriptions have almost doubled in the last decade in the UK. Opioid related hypogonadotropic hypogonadism is a well-recognised clinical entity. Opioid therapy as a cause of adrenal insufficiency is an under-recognised endocrinopathy with potentially lifethreatening adverse effects. We present the case of a 57 year old lady referred to the endocrine clinic with symptoms of generalised fatigue and weakness. Her...

A 47-year-old female presented with facial swelling, easy bruising, and concern regarding possible Cushing’s syndrome. She had developed secondary amenorrhoea 3 years previously; biochemistry suggested hypogonadotrophic hypogonadism, felt to be hypothalamic secondary to low BMI and intense exercise. She was normotensive, and BMI was 17.4. There was no evidence of abdominal striae, proximal myopathy or hirsutism, but her face appeared rounder and plethoric compared with a ...