Endocrine Abstracts

Section 1: Case history: A 55 year woman presented with a one month history of fatigue, anxiety, tremor and diarrhoea. She was diagnosed with Grave’s thyrotoxicosis and commenced on Carbimazole 30 mg daily. Thyroid hormones normalised, but after three weeks of therapy she developed rapidly progressive ascending numbness and weakness predominantly affecting her legs. Examination revealed distal symmetrical lower motor neurone weakness and widespread loss of light touch sensatio...

A 35 year old Asian man presented to the emergency department on several occasions with episodes of severe muscle weakness, affecting his arms and legs, to the point he was unable to walk or stand. He was found to be hypokalaemic on both occasions, at 2.3mmol/l and 3.0mmol/l respectively, and his weakness gradually improved with potassium replacement. He gave a history of two years of intermittent weakness and stiffness of the limbs which typically occurred at night or after l...

A 51-year-old man presented to an optometrist with a 3-week history of visual impairment following a minor headache. He was found to have reduced visual acuity 6/24 in both eyes and a dense bitemporal hemianopia and was referred urgently to Musgrove Park Emergency Department. MRI brain showed a cystic bleed from a pituitary macroadenoma, 30 mm in diameter, with compression of the optic chiasm. He had no clinical features of Cushing’s or other hormone excess or deficiency ...

A 66-year-old Caucasian male presented with polydipsia, profound weight loss, blood glucose of 29.1 millimoles per litre and mild acidosis. Urinalysis revealed no ketonuria. A mild acidosis was also identified. A bronzed skin appearance was noted which together with deranged liver function raised suspicions of haemochromatosis in conjunction with newly diagnosed diabetes. Initial treatment involved rehydration, intravenous then subcutaneous insulin therapy. Subsequent abdomina...

A 66-year-old Caucasian male presented with polydipsia, profound weight loss, blood glucose of 29.1 millimoles per litre and mild acidosis. Urinalysis revealed no ketonuria. A mild acidosis was also identified. A bronzed skin appearance was noted which together with deranged liver function raised suspicions of haemochromatosis in conjunction with newly diagnosed diabetes. Initial treatment involved rehydration, intravenous then subcutaneous insulin therapy. Subsequent abdomina...

Silent corticoptroph adenomas (SCA) are pituitary tumours positive on immunohistochemical staining for ACTH but without clinical evidence of hypercortisolism. They account for 1.1–6% of surgically removed pituitary adenomas. Most tumours are macroadenomas with suprasellar extension present in 87–100% of the cases. They present with mass effects and this is in contrast to Cushing’s disease, which is mostly attributed to microadenomas. Reports suggest that these t...

Background: Primary or idiopathic empty sella syndrome (ESS) is the herniation of the meninges through an incompetent diaphragma sellae into the sella turcica which pushes the pituitary gland aside so giving the appearance of an empty sella. Secondary ESS is caused by damage to pituitary tissue which results in an empty sella turcica. There is significant lack of agreement in the literature regarding the number of patients with empty sella syndrome (ESS) who suffer from pituit...