Endocrine Abstracts

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...

A 62 year old lady presented to the clinic with hirsutism, virilisation and temporal balding. Her past medical history included type 2 diabetes, hypothyroidism, ischaemic heart disease and peripheral vascular disease. Her body mass index was 30 kilograms per metre squared and she had mild cliteromegaly. Her serum testosterone was 3.6 nanomols per litre.She had a high dose dexamethasone suppression test and CRH test to exclude Cushings Syndrome or Disease...

Subcutaneous heparin is commonly used for prophylaxis of deep vein thrombosis. Heparin induced hypoaldosteronism can lead to hyperkalemia and natriuresis. These side effects are more common in elderly, renal insufficient and diabetic patients. We present a case with heparin induced hyperkalemia in a patient with diabetes.An 85 year old lady with insulin dependent diabetes mellitus of 32 years duration with peripheral neuropathy was admitted under the vas...

A 14 year old girl, with a family history of MEN1, presented with secondary amenorrhoea and weight gain. Biochemical investigation revealed raised 24-hour urinary free cortisol excretions (1455, 1190, 614 nmol/24 hours; normal <290) and failure of cortisol suppression following 48 hours of low dose (0.5 mg qds) dexamethasone (199 nmol/l to 202 nmol/l). High dose dexamethasone administration (2 mg qds) for 48 hours resulted in further suppression of serum cortisol to 49 nmo...

A 40 year old gentleman presented with dramatic weight loss and a rash in the perineal area spreading to involve his face, trunk, legs and feet. Initial investigations demonstrated a normocytic anaemia with no evidence of thyroid disease or diabetes. Occasional diarrhoea prompted subsequent investigations including upper GI endoscopy, duodenal biopsy, pancreatic exocrine testing and barium follow-through studies which were normal. His 24 hour urinary 5-hydroxyindoleacetic acid...

Background: Spinal Epidural Lipomatosis (SEL) is an excessive fat deposition in the spinal canal which can lead to compression of nervous structures. SEL is a rare but recognised side effect of exogenous steroid excess. There are only six previously reported cases of SEL associated with endogenous steroid excess in the available literature. We present a case of SEL, caused by Cushing’s disease, that presented in the immediate post-operative period.C...