Endocrine Abstracts

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency can have multiple effects on growth, sexual development, fertility and overall health. Sub-optimal adherence to treatment regimens during adolescence and puberty can have lifelong consequences. We present the case of 20-year-old male who was diagnosed at birth. His parents are first cousins, and his two siblings also have CAH. Initial treatment comprised hydrocortisone and fludrocortisone and administration ...

Hypothalamic amenorrhea is a diagnosis of exclusion. It accounts for 30% of cases of secondary amenorrhoea in women of reproductive age. It is caused by abnormal signalling between the hypothalamus and the pituitary gland due to deficient pulsatile secretion of GnRH. This reduced secretion of GnRH leads to levels of LH and FSH that are insufficient to maintain full folliculogenesis and normal ovulatory ovarian function, with consequent oestrogen deficiency. There are many caus...

Osteoporosis is estimated to effect more than 3 million people in UK and secondary osteoporosis accounts for about 30% of women and 55% of men with vertebral fractures. There are many causes of secondary osteoporosis, such as endocrine, gastrointestinal disorders, steroid use, as well as immobility, obesity, bulimia and anorexia nervosa. We present a case of Osteoporosis secondary to anorexia nervosa.77 year”s old lady initially referred to bone clinic at the age of 46 wi...

Hyponatraemia is the most common electrolyte abnormality encountered in clinical practice and second most common endocrine referral. Acute severe hyponatremia is potentially life-threatening and must be treated promptly and aggressively. SIADH, Cortisol deficiency, Liver Disease, Heart disease, certain medications and excess alcohol intake can frequently lead to hyponatremia. We present a case of 41 year old male known to have alcoholic liver disease and depression who present...

Background: A 29 year old female presented to the Emergency department with headache, vomiting and loose stools for 24 hours. She was not known to have diabetes. She had a background of bilateral sensorineural deafness for 6 years and resolved Gillian Barre syndrome 8 years prior. She has a family history of deafness and diabetes mellitus in her maternal grandmother and mother; and diabetes in her maternal aunty and two maternal uncles diagnosed with prediabetes. She has a par...

Introduction: Waterhouse Friedrichsen syndrome-Severe adrenal insufficiency is a rare but life-threatening condition secondary to bilateral adrenal haemorrhages. In many cases, it is caused by fulminant meningococcaemia, but there are numerous other aetiologies, it can also be caused by use of medications that promote blood clotting, reduce platelet count, primary antiphospholipid syndrome, renal vein thrombosis or steroid use and has been associated with splenectomy as well. ...

Background: We present an interesting case of a 56 year old male who, during pre–operative work up, was found to have a very low HbA1C 3.1% (10 mmol/mol). The patient was also noted to have mild thrombocytopenia, raised bilirubin and alanine aminotransferase and moderate splenomegaly on CT scan, with otherwise normal appearance of remaining abdominal viscera. His past medical history included alcohol excess (60–80 units/week), he was not diabetic and was taking Asp...

Introduction: Vitamin D toxicity (VDT) is quite an uncommon condition which results from misperception between dosage regimens of vitamin D supplementation. VDT is diagnosed when Serum 25-hydroxyvitamin D levels are higher than 375 nmol/l (150 ng/ml). Vitamin D supplementation is easily accessible as over-counter medication and online. This report describes a patient who presented with severe hypercalcemia and acute kidney injury (AKI). Further assessment revealed that patient...

Introduction: Ectopic Cushing’s syndrome constitutes the second most common paraneoplastic syndrome and has been seen in 1-5 % of small cell lung cancers. It has a poor prognosis and can present with life-threatening complications.Case: We present a 66-year-old lady who attended with peripheral oedema, bruising and visual blurring. Past medical history included bronchiectasis, oesophageal web, ischemic colitis, Ehlers Danlos syndrome, and hypoxic br...

Carbimazole is one of the most commonly prescribed endocrine medications. There are a wide range of side effects associated including bone marrow disorders, severe cutaneous reactions, agranulocytosis and vasculitis. There have been few reports of anti-thyroid associated arthritis, described as migratory arthritis with prompt resolution following medication discontinuation. Side effects reported in British national Formulary and Electronic Medicine Compendium include myopathy ...