Endocrine Abstracts

A 37-year healthy man initially presented to primary care with weight loss and palpitations and diagnosed to have thyrotoxicosis based on thyroid function tests (TFT) – TSH (< 0.05; n = 0.27-4.20μIU/l), FT4 (59.8; n = 12-22 pmol/l), and FT3 (32; n = 3.1-6.8pmol/l) . CBZ was started and 4-weeks later was seen in the Endocrine clinic where Graves’ disease was confirmed based on a goitre and positive antiTSH receptor antibody. However...

Introduction: Lymphocytic hypophysitis(LH) is a rare autoimmune endocrinopathy that causes pituitary gland inflammation, resulting in hypopituitarism. Headache is the most common presenting symptom; however, diabetes insipidus (DI) may be the first feature in some patients. Here we report one such case. Case: a 36-year-old female was referred to the Endocrine clinic with sudden onset of polydipsia, polyuria and nocturia. She also reported amenorrhoea but...

We present an interesting case of immobilisation hypercalcaemia. Case: A 22-year-old female with no significant past medical history was admitted following a road traffic accident (RTA). She suffered severe abdominal injury, skull and multiple limb fractures and underwent left below-knee amputation, bowel resection and nephrostomy. The admission to ITU was prolonged, and seven weeks into the admission, she developed hypercalcaemia (adjusted calcium: 3.8, N: 2.2 – 2.6 mmol...

Background: Functional hypothalamic amenorrhoea (FHA) is a common cause of secondary amenorrhoea and is related to a combination of weight-loss, exercise and psychological stressors. These factors lead to suppression of pulsatile GnRH secretion. Diminished LH and FSH concentrations result in a hypoestrogenic state. We present an archetypal case of FHA that clearly demonstrates the ‘hypothalamic set-point’ for the body composition of a young woman below which...

Introduction: Grave”s disease (GD) is a common cause of thyrotoxicosis, Myasthenia Gravis (MG) is less common (incidence of 3-30cases per million). Between 5-10% of patients with MG also have thyroid disease. However, only 0.14% of patients with GD having MG. Both are autoimmune diseases sharing pathophysiological mechanisms. Co-existence, although rare, is well established. MG may mimic the neuromuscular signs of GD especially if these are subtle. We report a case of a 3...

Introduction: Hyperprolactinaemia, amenorrhoea with ophthalmoplegia and radiological abnormalities in suprasellar region usually suggest a pituitary tumour. We present a case of carotico-cavernous sinus fistula causing pituitary engorgement (CCF) mimicking pituitary tumour.Case history: 45 year old female with background history of long term amenorrhea, migraine admitted under Neurology with worsening headache, nausea, vomiting and blurred vision. There ...

Introduction: Hypokalaemia is a common biochemical abnormality seen in inpatients; it is usually mild and iatrogenic. We report a rare case of muscle paralysis due to severe unprovoked hypokalaemia, presenting on acute medical take.Case: The patient presented with a two week history of epigastric pain, nausea, vomiting, muscle spasms and dizziness. Past medical history included asthma, vitiligo, pernicious anaemia as well as long standing history of unex...

Introduction: We present a challenging case of central diabetes insipidus secondary to hypothalamic large B cell lymphoma. These are rare tumors accounting for less than 1% of lymphomas. Conventional treatment involves the MATRIX regime (methotrexate, rituximab, thiotepa, cytarabine) chemotherapy, coupled with intensive intravenous fluid therapy to avoid methotrexate toxicity. The main challenges in the management of this case were maintaining fluid and electrolyte balance in ...

Introduction: Pheochromocytomas (adrenal and extra- adrenal/Paragangliomas) are rare catecholamine producing tumors and required complex dedicated MDTintervention. We preliminarily reported our service in a tertiary referral centre over 10 years (2008–2018).Method: A retrospectively review of confirmed phaeochromocytoma were carried out by reviewing clinical correspondences and ICE investigation-result system (laboratory, radiology and histology.)</...