Endocrine Abstracts

Water balance disorders following neurosurgery are well recognised and may give rise to both hypo- and hypernatraemia. We present the case of a 42-year-old male who developed a triphasic response after extended transsphenoidal surgery for a pituitary stalk lesion. The patient presented with a 4 month history of unremitting frontal headaches and dizziness. MRI confirmed a 15×15 mm stalk lesion. Clinical examination including formal visual perimetry was unremarkable. Blood ...

Case history: A previously asymptomatic 58-year-old gentleman presented following an out-of-hospital cardiac arrest, precipitated by multiple, bilateral pulmonary emboli.Investigations: In the course of investigation, a 35 mm, MIBG-negative, right adrenal lesion was discovered. Functional adrenal tests revealed significantly elevated normetanephrine and 3-methoxytyramine levels. Severe hypertension and type 2 diabetes were concurrently diagnosed.<p c...

Case history: An 18-year old lady being investigated for anaemia, was incidentally found to have a 15 cm left adrenal mass. History taking revealed a 6-month history of weight gain, fatigue, and hirsutism. Past medical history was positive for mental illness. There was no learning disability or history of epilepsy. Physical examination was unremarkable.Investigations: Biochemical work-up for a functional adenoma revealed normal serum cortisol and circadi...

Context: Hyponatraemia is the most common electrolyte balance disorder in clinical practice, amounting to 15–20% of casualty visits. While there is general agreement that associated mortality rates are high, most studies are uncontrolled.Objective: To determine the characteristics, causes and outcome of severe hyponatraemia (<125 mmol/l) in hospitalised patients and to indentify mortality predictors.Design: This is a retro...

Introduction: Hirsutism is the presence of excess hair growth in females as a result of increased androgen production and/or increased skin sensitivity to androgens. In a postmenopausal female presenting with hirsutism, a high level of clinical suspicion, a detailed history and physical examination, substantiated by focused biochemical and morphological confirmation is necessary.History: The authors present a case of a female with a longstanding history ...

A 35 year-old lady presented to her local hospital with a 3 year history of fatigue, weight gain, recurrent tonsillitis and oligomenorrhoea. Examination revealed facial plethora, round facies and thin skin on the dorsum of the hand. She appeared tanned, with evidence of spontaneous bruising and difficulty standing up from a chair unaided. No striae were present. Blood pressure was 152/91 mmHg. Investigations revealed a 0900 h cortisol of 632 nmol/l (ACTH 59 ng/l) and an elevat...

A 21-year-old woman with homozygous sickle cell disease, presented to A&E with vomiting and diarrhoea, and was noted to be hypercalcaemic (corrected calcium 3.00 mmol/l [ref. 2.2–2.6]; phosphate 0.48 mmol/l [ref. 0.8–1.5]). She reported polyuria and polydipsia, but no other symptoms of hypercalcaemia. There was no history of renal stones, renal impairment, or fragility fracture. A maternal aunt required parathyroidectomy in middle age. Bloods revealed PTH 138.4 pmo...

Section 1: Case history: We present the case of a 21-year-old lady known to harbour a homozygous inactivating mutation of the calcium sensing receptor (CaSR) which led to uncontrolled hypercalcaemia in infancy, necessitating emergency total parathyroidectomy. The CaSR plays an important role in calcium homeostasis. Inactivating mutations result in a higher calcium “set-point” and various degrees of hypercalcaemia based on the severity of functional impairment. In the...

ObjectiveActive acromegaly is associated with increased mortality. While surgery is the mainstay of treatment, it is not always curative. In selected cases, CyberKnife stereotactic radiosurgery (CK SRS) can be used as adjuvant treatment in patients with persistent disease.DesignThis is a retrospective review of the biochemical and imaging characteristics for patients with active acromegaly treated with CK SRS...