Endocrine Abstracts

A 69 year old man had a 5 cm right adrenal lesion discovered incidentally while being investigated for a deterioration in previously well-controlled hypertension. Routine investigations including serum albumin were normal. Further investigation confirmed a non-functioning adrenal lesion. MRI revealed a ’non-fat-containing T1 hyperintense indeterminate adrenal lesion with speckling of T2 hyperintensity, not typical for adenoma, hyperplasia, myelolipoma, haemangioma or pheo...

A man presented at age 32 with clinical features of Cushing’s syndrome and biochemical investigations were consistent with ectopic ACTH. The only potential source on imaging was a 5 mm right lung nodule on chest CT but which was too small to biopsy. Medical therapy was not successful at controlling his Cushing’s features so he was referred for thoracotomy. Following lobectomy, the lung nodule was found to be a carcinoid tumour. Post operatively, the patient’s sy...

Management of type-2 diabetes (T2D) should be individualised given recent increase in treatment options. There is a spectrum of phenotype of T2D from thinner patients who may be more insulin deficient to those who are overweight/obese and insulin resistant. We hypothesized that, if we are personalising treatment, thinner patients would be more likely to be treated with insulin secretagogues. To compare the management between these phenotypes, we reviewed 1007 patients with T2D...

Elevated serum prolactin (PRL) is common, with many potential causes. We performed a retrospective audit of patients with hyperprolactinaemia from 2006 to 2008, aiming to identify the clinical indications for prolactin testing, the aetiology identified and the treatment instigated. Medical notes for 83 patients (55 female, mean age 41 years (range 17–95)) with PRL >700 mU/l were retrospectively reviewed. Indications for testing included: seizure or suspected seizure (...

A 44 year old woman presented with leg swelling. Past history included hypothyroidism and ulcerative colitis treated with eltroxin (100 mg/day) and azathioprine (100 mg/day) respectively. Clinical examination revealed pitting oedema to knees and a ’puffy face’. Free T4 was 5.8 pmol/l (12–22 pmol/l), TSH 84.61 mU/l (0.27–4.20), serum albumin 24 g/l (40–49 g/l). She reported good compliance with L-thyroxine and no recent gastrointestinal symptoms. L-thyr...

A 20-year-old woman, with type 1 diabetes, presented to Emergency Department complaining of abdominal pain and vomiting for 3 days. She reported intermittent non-compliance with insulin therapy. Physical examination revealed epigastric tenderness. Blood glucose was 34.6 mmol/l, blood ketones 7.8 mmol/l, creatinine 131 µmol/l and CRP 31.47 mg/l (< 10). Despite clinical and initial laboratory features suggesting diabetic ketoacidosis, pH was 7.52 (7.32–7.43), pCO<s...

Acromegalic congestive cardiac failure (CCF) is a serious and late complication of untreated acromegaly with associated high morbidity and mortality.1 Spontaneous recovery of end stage acromegalic CCF following autoinfarction of a somatotroph adenoma has not been previously reported.We report the case of a 61-year-old woman who presented with features of severe biventricular CCF and an acromegalic phenotype. Echocardiography revealed poor LV f...

Introduction: Fine needle aspiration cytology (FNAC) is a widely adopted pre-operative investigatory tool for thyroid nodules. The British Thyroid Association (BTA) recently updated guidelines recommending that an FNAC that initially yields benign cytology (Thy2) should be repeated if there is any clinical or ultrasound (US) suspicion (1). We postulate that there is a tendency for a more conservative approach in older age groups with smaller thyroid nodules on US studies.<...