Endocrine Abstracts

A 35year old man presented to the cardiology clinic with effort dyspnoea, palpitations and light-headedness. He had just returned from a 6 month “round the world’ trip during which he had suffered a diarrhoeal illness. An echocardiogram performed in Bangkok revealed left ventricular dilatation but no other significant changes. A diagnosis of possible myocarditis was entertained and he was treated with 2.5 mg of Ramipril and 75 mg of Aspirin. When seen in the cardiolo...

Autoimmune adrenal insufficiency may be familial or non familial. We report a case of identical female twins, both with Addison’s disease and detectable antibodies to adrenal cortex.Case report: Twin A at age of 27 developed Addison’s disease and hypothyroidism. She was found to be positive for anti-adrenal antibodies, anti-thyroid antibodies and intrinsic factor auto antibodies. Therefore Twin B was tested for the same auto antibodies and was ...

The effects of IGF-2 on glucose homeostasis have been more understood from individuals with fasting hypoglycaemia associated with non-islet cell tumours. Endogenous IGFs which circulate in adults fail to exert their immense potential hypoglycaemic activity because they are largely trapped within the vascular space due to their sequestration in a high molecular weight protein complex. The tumours produce excessive amounts of ‘big IGF-2’ which is less readily bound by ...

Patients with Cushing's disease have high levels of circulating corticosteroids. Treatment may result in unmasking of steroid dependant conditions. We report a case of ulcerative colitis presenting after bilateral adrenalectomy.Case reportA 19 year old girl underwent bilateral adrenalectomy in November 1998 for pituitary dependant Cushing's disease. She was discharged on hydrocortisone and fludrocortisone and post operatively her c...

We present the case of a 34 year old man, previously well, who presented with a 4 week history of worsening headaches and confusion.He was disorientated and confused, but the rest of the examination was largely unremarkable. Admission blood tests revealed him to be profoundly hyponatraemic (serum sodium 100 millimoles per litre, urine sodium 72 millimoles per litre, serum osmolality 202 milliosmoles per kilogram, urinary osmolality 851 millimoles per kil...

It is recognised that growth hormone deficiency causes disturbances in reproductive function. Indeed growth hormone has been used for ovulation induction in the treatment of subfertility in women with hypopituitarism. During normal pregnancy growth hormone is produced by the placenta (placental growth hormone). From 15 to 20 weeks gestation placental growth hormone gradually replaces pituitary growth hormone in the maternal circulation and is the main determinant of maternal I...

We present the case of a Caucasian girl who in 1991 at the age of 4 started virilising and was diagnosed to have 21-hydroxylase deficiency. She started her periods at 10 and has been under regular follow up. In 2004 she underwent vaginoplasty and clitoral reduction and made good recovery. She has been stable on hydrocortisone 10 mg in the morning, 12.5 mg in the evening and fludrocortisone 50 mcg once daily (Testosterone<0.7 mmol/l (0.5–3.0), 17-hydroxy progesterone=1...

We present the case of a 32-year-old gentleman who was initially referred to the urologists with erectile dysfunction, low libido and infertility. There was no history of headache, visual difficulty, galactorrhea and his smell sensation was fine. Blood tests done in February 2007 showed normal renal, liver and thyroid function. His Prolactin was elevated at 3086 mU/l, with no detectable macroprolactin. He had hypogonadotrophic hypogonadism (testosterone=1.8 nmol/l (10–40)...

A 32 year old man with a history of epilepsy since childhood presented in 1992 with a grand mal seizure and clinical features of tuberous sclerosis (TSC). One year later he was referred with classical Cushingoid features. His serum Na was 140 mmol/l, K 3.4 mmol/l, 9 AM cortisol 1018 nmol/l with lack of diurnal variation and ACTH 42-50 ng/l. Urinary cortisol: 797 nmol/24 h. After overnight, low and high dose dexamethasone suppression, cortisol was 1018, 1154, and 62 nmol/l resp...