Endocrine Abstracts

Case: A 20 year old female was referred for further evaluation of ovarian function. She has a history of beta thalassemia and bone marrow transplant in 2009 at age 11. Her menarche started in 2008 and she continued having regular periods until shortly after her bone marrow transplant. She was subsequently started on Loestrin oral contraceptive pill. Examination showed a height of 164 cm and weight of 57 kg. She had well developed secondary sexual characteristics. Her OCPs was ...

Case: A 34 year old was reviewed in reproductive clinic for gonadotropins therapy prior to micro-TESE. He was diagnosed with Klinefelter syndrome in his 20s in another hospital. Testosterone replacement was initiated with Nebido injection. However, he developed polycythemia, DVT and PE in 2013 and therefore the testosterone replacement was stopped. He had thrombophilia screen that showed heterozygous prothrombin gene mutation. Thereafter, he received anticoagulation for few mo...

Background: Current Endocrine Society guideline recommends a single prolactin level to confirm the diagnosis of hyperprolactinemia. This may lead to over diagnosis and inappropriate imaging. Our institution protocol is to repeat the prolactin and measure macroprolactin. If the second prolactin is elevated, then a cannulated prolactin to role out venipuncture stress effect is undertaken.Methods: Data were collected for 49 patients between January 2017 to ...

Background: The blood supply of the pituitary gland comes via a portal circulation from the hypothalamus. During pregnancy, the anterior pituitary gland enlarges but the blood supply cannot increase, as it is derived from a capillary plexus. The pituitary is thus vulnerable to arterial pressure changes and infarction secondary to hypotension. We describe a case of a male patient with large pituitary adenoma who developed Sheehan’s like syndrome due to adenoma infarction s...

Case History: A 64 year old lady with osteoporosis was referred for parental antiresorptive therapy due to a history of oral bisphosphonate intolerance. She was screened for osteoporosis at age 53 after her mother suffered a hip fracture, DEXA showing an L2-L4 T score of −2.5 and mean femur −2.2. She was given a trial of alendronate, but stopped due to indigestion. On Calcium and Vitamin D supplementation, the DEXA after 4 years showed improvement of both the spine...

Case history: A 66 year old lady presented with abdominal pain, new onset diabetes and hypertension. She was diagnosed with Cushing’s syndrome and was found to have a large heterogeneous left adrenal mass of 11.4 × 9.3 cm in size with no disease elsewhere. She underwent a left open adrenalectomy and the histology confirmed an adrenocortical carcinoma (Weiss score of 7) with focal vascular invasion, no extra-capsular spread and clear resection margins. Following surge...

Case History: A 64 year old lady was referred for parental antiresorptive therapy due to a history of oral bisphosphonate intolerance. She had been screened for osteoporosis at age 53 after her mother had suffered a hip fracture, DEXA scan showed an L2-L4 T score of −2.5 and a mean femur −2.2. She was given a trial of alendronate, but had stopped due to indigestion. The DEXA scan at 4 years showed improvement of both the spine and femur densities on Calcium and Vit...

Aim: Recent studies reported a wide range in baseline and peak cortisol responses to surgery. We report the results of cosyntropin stimulation testing following unilateral adrenalectomy for non-steroid secreting lesions.Methods: Data of 36 patients who underwent cosyntropin stimulation testing on the second day post unilateral adrenalectomy were collected retrospectively. None of the patients had clinical signs of hypercortisolism. No patient received pr...

Case: A 46-year-old woman was initially investigated for right sided intermittent headaches for one year. Her MRI head revealed a pituitary adenoma. She had no history of vomiting with the headache episodes and had no history of visual acuity or field defect. She had amenorrhoea for the past 10 months. Prior to this, she had regular periods following her menarche at the age of 12 years. She admitted to easy bruising but had no hirsutism or acne. She did not report any weight g...

A 59 year old man was referred to our endocrine service for persistently elevated prolactin levels. He did not report any headache, visual disturbance or galactorrhoea. He was diagnosed with schizophrenia in 1994 and was tried on different antiphychotic drugs until established on a combination of Amisulpride and Clozapine 11 years later. For the past years, his prolactin levels had been elevated ranging from 1477 to 1972 milliunit/L [60–300]. Further history revealed that...