Endocrine Abstracts

Transformation of a micro-prolactinoma to a macro-prolactinoma during pregnancy is rare. During treatment of micro-prolactinoma it is conventional to stop dopamine agonist treatment prior to or at conception and only re-image the pituitary if the patient presents with symptoms or signs of pituitary enlargement. We present two cases of micro-prolactinoma transforming to macro-prolactinoma during pregnancy. Neither case presented with symptoms or signs of pituitary enlargement. ...

Adrenal incidentalomas are increasingly recognised with the use of abdominal imaging with prevalence ranging from 0.35-0.45%. The vast majority of these are benign adrenocortical adenomas. Increasingly, subclinical hypercortisolism is recognised in such cases.We describe a case of a 34-year-old asymptomatic primigravida with chance recognition of an adrenal mass during an obstetric ultrasound. Biochemical testing revealed consistently normal urinary catecholamine and eleva...

We present two cases with biochemistry results suggesting thyrotoxicosis, caused by laboratory artefacts.Case 1: A 68-year-old male with type 2 diabetes was referred with weight loss. Results showed fT4 of 30.5 and TSH of 1.07, confirmed on repeat. He had no symptoms of hyperthyroidism.Blood was sent for treatment with antibody-blocking reagents:...

Hypomagnesaemia can cause Hypocalcaemia as magnesium interferes with parathyroid hormone action and secretion. It also causes hypokalemia due to defective membrane ATPase or urinary potassium loss. We present two patients who were admitted to our hospital with symptoms and signs of hypocalcaemia secondary to drug-induced hypomagnesaemia and describe the lessons learned.Patient 1: A 46 year-old lady presented with “pins and needles” and muscle c...

Prolactinomas are the most common pituitary adenomas. The treatment is primarily medical with dopamine agonists. The improvements in prolactin levels are accompanied by reduction in the tumour size in the majority of cases. We report a patient with a macroprolactinoma whose tumour enlarged despite achieving normal prolactin levels.A 55-year-old gentleman was referred to the ophthalmologist with worsening vision in the left eye. Clinical examination revea...

Hirsutism affects 8% of women and forms an important reason for referral to the endocrine services in patients with polycystic ovarian syndrome (PCOS). Although antiandrogens are the mainstay in treatment, one needs to bear in mind that they are not without undesirable side effects.We present the case of a 37-year old woman, diagnosed with PCOS based on menstrual irregularities and typical ultrasound appearances of her ovaries. Her main concerns were hir...

Aim: To evaluate local management of thyroid nodules in comparison with the British Thyroid Association guidelines.Methods: All patients who had fine needle aspiration cytology (FNAC) for a thyroid nodule in 2004 and 2005 were included. Data collected included: patients’ age, gender, thyroid status, FNA Cytology (including repeats) and THY classification, surgical intervention and histology (if applicable).Results: 97 patients...

Polycystic ovarian syndrome (PCOS) is a common disorder affecting women of childbearing age. The clinical triad of PCOS includes: hirsuitism, oligo/amenorrhoea and ultrasonographic appearances of PCOS. However, this triad could occur in other disorders such as late onset congenital adrenal hyperplasia (CAH). Although CAH is mainly diagnosed in childhood, it could occur in adults. In this abstract we describe a patient who presented with features of PCOS, the final diagnosis, h...

Once daily Thyroxine is the treatment of choice for hypothyroidism. The dose of Thyroxine needed varies with a mean of 1.6 mcg/kg bodyweight a day. The most common cause for requiring larger doses is non-compliance although other causes such as malabsorption and drugs should be excluded. In this abstract we describe two patients with hypothyroidism that required large doses of thyroxine secondary to poor compliance in which supervised once weekly thyroxine therap...

Aim: To audit radioactive iodine (RAI) treatment.Methods : A retrospective audit of thyrotoxic patients, who attended the one-stop RAI clinic, between April 2005 and February 2006.Results: We included 74 patients (60 females, 14 males) with a median age 54 (22–85) years.Before RAI: Smoking history was recorded in 19/74(26%) patients. 44/74(59%) patients received drug treatment for two years or mor...