Endocrine Abstracts

Case history: Fifty-eight years old gentleman referred to endocrinology with erectile dysfunction and decreased libido for 1 year. He denied headache or visual disturbance. His past medical history include ulcerative colitis (1998), mild asthma, anterior scleritis (2003), previous DVT (1994), Episode of steroid induced psychosis in past. He is on levothyroxine, sulfasalazine, calcium /vitamin D and long term prednisolone 4 mg (9 years). Examination reveal testicular volume of ...

We report two cases of unilateral and bilateral phaeochromocytoma in patients with neurofibromatosis type 1 (NF-1) respectively.Case 1 64 year old Caucasian male with known NF-1, hypertension, depression and osteoarthritis was referred with episodic symptoms of palpitation, chest pain and breathlessness. Biochemically confirmed phaeochromocytoma with 24 hr urinary metanephrines of 18595 nmol/24 hrs. CT revealed 4.2 cm right adrenal...

Case 1: 38 year old was referred for sub-fertility. She had one normal childbirth 5 years ago. There was failure to lactate following the childbirth. There was some puerperal blood loss, but she resumed normal menstrual periods and had no other manifestations of hypopituitarism. Pituitary profile showed normal results FSH 2.7 IU/l; LH 1.5 IU/l; 0900 h cortisol 305 nmol/l/l/ TSH 2.85 μ/l. Prolactin was 85 μ/l. IGF1 18.6 nmol/l. Short synacthen was normal. Previous MRI...

Radiation to the neck is known to be associated with the later development of hypothyroidism. The possibility of acute radiation-induced thyrotoxicosis is not generally recognised. We report here a case of acute hyperthyroidism shortly after radiotherapy.A 57-year-old man with poorly differentiated adenocarcinoma of the left parotid underwent parotidectomy with radical neck dissection followed by radiotherapy. He received 65 Gy by intensity modulated rad...

Case history: A 29-year-old man presented with infertility. He also complained of difficulty in passing urine. He also complained of low libido and ejaculate was also noted to be watery. He complained of occasional difficulty in maintaining erections. He denied history of trauma, radiation exposure or use of illicit drugs. He had normal pubertal development and secondary sexual features. He had undergone a surgery about 11 years ago in Nigeria for hypospadias. Hypospadias was ...

A 36-year-old woman was admitted with newly diagnosed Grave’s disease due to significant symptoms. Blood results revealed fT4 83.2 (pmol/l) TSH <0.01 (mIU/l), and TSH Receptor Antibody 4.56 (0-0.4 U/l)). She was commenced on Propylthiouracil (PTU) thrice daily alongside Propranolol. She had a blood test in 4 months’ time, when she was 5 weeks pregnant. Blood results suggested profound hypothyroidism with fT4 4.7 (pmol/l) and TSH 82.02 (mIU/l), and she was commenc...

Coexistence of primary hyperparathyroidism and multiple myeloma is very rare.Case report: 45 year old Jamaican female presented with left sided chest pain for a month. CXR showed a pathological left clavicular fracture with a lytic lesion. She was noted to have a serum Ca of 3.26 mmol/l.Other investigations: Haemoglobin 115 g/l (115–155), creatinine 76 umol/l (49–92), Corrected Ca 3.26 mmol/l (2.20–2.60), Phosphate 0...

Myxoedema coma is a rare Endocrine emergency.Case report: 28 year old Polish woman, recently travelled to the UK, presented to the A&E with 3 week history of breathlessness and bilateral leg swelling. She had a history of Trisomy 21, was not taking any medications. She had amenorrhoea for 4 months and orthopnoea with periorbital oedema with conjunctival congestion. Saturation 70% on air, 96% on 15 l of oxygen, heart rate 42, blood pressure 103/61, te...

Case History: 38 year old male presented with thyrotoxic symptoms and exophthalmos with an initial Free T4 of > 100 pmol/l; TSH < 0.01 mIU/l and thyroid receptor antibody positivity. He had a platelet count of 72* 109 /L at presentation and was started on carbimazole. A month later he had platelet count of 9* 109 /L with normal white cell count and haemoglobin levels. He was switched to propylthiouracil, but was readmitted with platelet count of 1...

Neuromyelitis Optica (NMO) is a neuro-inflammatory condition usually presenting with optic nerve and spinal cord events, caused by autoimmunity to Aquaporin 4 (AQ4) channels in the central nervous system (CNS). The high density of AQ4 channels in the hypothalamus and area postrema mean that NMO can occasionally present with atypical features. We present a 56-year old South Asian man, who presented with hiccoughs and Syndrome of inappropriate antidiuretic hormone (SIADH ) and w...