Endocrine Abstracts

Introduction: Testicular adrenal rest tumours (TART) are benign corticotrophin-dependent tumours that occur in males with congenital adrenal hyperplasia (CAH). We present a patient with bilateral large TART as a consequence of poor compliance to treatment and follow-up for his CAH.Case: A 25-year-old gentleman presented to the endocrine clinic in 2009 with a history of tiredness, reduced libido and bilateral large testicles, which he wanted surgically re...

Introduction: There are reports of patients having co-existing primary hyperparathyroidism and familial hypocalciuric hypercalcaemia (FHH). The combination of relative hypocalciuria, hypercalcaemia and slightly elevated serum parathyroid hormone (PTH) could indicate FHH. Medications such as, lithium and bendroflumethiazide can reduce renal excretion of calcium. We report a case highlighting the importance of being aware of drug-induced hypocalciuria during the investigation of...

Introduction: Prolonged therapy (≥ 3 months) with high-dose corticosteroids (≥ 7.5 mg Prednisolone or 1–1.5 mg Dexamethasone daily) can result in adrenal atrophy and secondary adrenal failure. Abrupt withdrawal of corticosteroids after prolonged use can lead to adrenal insufficiency, corticosteroid withdrawal symptoms or a relapse of the initial disease. A safe flexible management plan is required for each patient. We illustrate with two cases.<p class="ab...

Introduction: Lithium associated hyperparathyroidism (LAH) resulting in hypercalcaemia is a known problem. Treatment options are limited in frail elderly patients with multiple co-morbidities, in whom parathyroid surgery could be dangerous. Cinacalcet, a calcimimetic agent can be an alternative option. We report a case of an elderly lady on Lithium, who was initiated on Cinacalcet for hypercalcaemia and has had to continue the Lithium for her bipolar affective disorder.<p ...

Introduction: Klinefelter’s syndrome (KFS) is associated with an increased risk of certain malignancies; including leukemia, breast cancer and mediastinal germ cell tumours. Testicular tumours are uncommon. Epidermoid cysts are benign tumours of hair-growing areas. Testicular epidermoid cysts are very rare and account for 1–2% of all testicular tumours. We report a rare case of bilateral epidermoid cysts in a patient with Klinefelter’s syndrome.<p class="abs...

Introduction: Hyponatraemia is the commonest electrolyte disturbance affecting patients in and out of hospital. Streamlining and improving the investigation of hyponatraemia will quicken diagnosis, improve patient outcomes and prevent deterioration and unnecessary stay in hospital. We aimed to audit the assessment of patients with hyponatraemia against our existing guidelines (Hyponatraemia – An Investigator’s Checklist).<p class="abst...

Introduction: Single-electrolyte derangement is a common biochemical finding. Multiple-electrolytes derangement is less common and require multiple and simultaneous corrective therapies. We present a patient who had multiple admissions with multiple-electrolytes derangement, which after further evaluation required a single therapeutic intervention.Case: A 26-year-old lady had eight admissions over three years with abdominal pain and vomiting. During each...

Introduction: Hyponatraemia is the commonest electrolyte disturbance affecting patients in and out of hospital. Streamlining and improving the investigation of hyponatraemia will quicken diagnosis, improve patient outcomes and prevent deterioration and unnecessary stay in hospital. We aimed to audit the assessment of patients with hyponatraemia against our existing guidelines (Hyponatraemia – An Investigator’s Checklist).<p class="abst...

Introduction: Single-electrolyte derangement is a common biochemical finding. Multiple-electrolytes derangement is less common and require multiple and simultaneous corrective therapies. We present a patient who had multiple admissions with multiple-electrolytes derangement, which after further evaluation required a single therapeutic intervention.Case: A 26-year-old lady had eight admissions over three years with abdominal pain and vomiting. During each...

Introduction: Acromegaly is a rare metabolic condition in adults caused by over secretion of growth hormone from the pituitary gland. The characteristic skeletal and organ overgrowth and dental mal-occlusion issues are so insidious that they go unnoticed by the patient and family. The dentist may be the first healthcare provider to see these patients, thereby proving instrumental in early diagnosis. We report two cases of acromegaly: one case identified by a dentist and anothe...