Endocrine Abstracts

Pancreatitis has multiple aetiologies of which commonest are gall stones and alcohol. Hypertriglyceridaemia is a less common (1-14 %) cause of pancreatitis. We present three case histories of acute pancreatitis due to severe triglyceridaemia and its management challenge in people with diabetes.Case history: 1. A 33-year-old man with BMI of 41 kg/m2 with Hodgkin lymphoma, thyrotoxicosis and diabetes, but no history of alcohol use was diagnosed ...

A 61-year-old lady presented to her general practitioner in July 2018 with weight loss, loose stools, hair loss, increased anxiety and dry eyes over several weeks. Blood tests revealed Graves’ thyrotoxicosis (TSH< 0.10 mU/l, (RR) 0.30-5.50 mU/l; Free T4 (fT4) 26.1 pmol/l, RR 11.5−22.7 pmol/l; Free T3 (fT3) 11.8 pmol/l, RR 0.0-7.0 pmol/l, thyroid receptor antibodies >40.0U/l, RR 0.0-1.8 U/l; thyroid peroxidase antibodies 173.0 iu/ml, RR 0.0-33.9 iu/ml). There...

We present the case history of a 48-year-old man with anxiety and depression, who was referred for evaluation of absent libido, long standing erectile dysfunction and reduced body hair. There was no history of orchitis, pituitary problems or low impact fractures. He was always single and did not father children. Clinical examination revealed obesity (BMI 31 kg/m2), absent facial hair, reduced body, axillary and pubic hair. There was bilateral gynaecomastia. The phallus was nor...

An 84-year-old lady with hypertension, bladder cancer, and chronic kidney disease, presented with a 3-day history of diplopia on looking to the right, abnormal eye movements, right-sided peri-orbital headache, and diarrhoea. Clinical examination revealed right-sided sixth cranial nerve palsy with normal pupillary light reaction, visual acuity, and visual fields. There were no other neurological deficits. The patient did not have features of hypercortisolism, GH excess, or adre...

Introduction: Klinefelter syndrome may involve multiple organ systems. The CNS, magnetic resonance brain imaging (MRI) findings (white matter changes, reduction in ventricular volume and brain size) are under recognised.We present the case report of a 47-year-old man with schizophrenia who presented with a 4-month history of lethargy, self-neglect and decline in cognitive function. Brain MRI revealed abnormal white matter changes in left frontal and temp...

Case history: An 81 years old lady with treated follicular lymphoma, hypertension and osteoporosis was admitted to hospital with a fall and was found to have hypercalcaemia with adjusted calcium of 4.9 mmol/l (nr 2.2–2.6 mmol/l). There was history of constipation but no history of excessive thirst or polyuria. The patient was on atorvastatin, amlodipine, bendroflumethiazide, ramipril, calcium and vitamin D. On examination our patient was dehydrated and mildly confused. There w...

A 45-year-old man with obesity (BMI 36 kg/m2) was admitted with a 12-hour history of headache and confusion and managed for viral meningitis. Treatment was discontinued after CSF viral PCR was negative. At presentation, he was hypoglycaemic with a capillary glucose of 1.6 mmol/l. Past medical history was not significant and there were no similar episodes previously. He denied taking insulin, other medications, illicit drugs or alcohol. Initial investigations reveale...

A 32-year-old man presented with a four year history of reduced libido, erectile dysfunction and inability to conceive with his partner. He went through puberty normally and had a normal sense of smell. Clinical examination revealed that he was 205 cm tall and normally virilised. Testicular volume was reduced, but the phallus was normal. Clinically, he appeared euthyroid and there were no features of hypercortisolism or growth hormone excess. Biochemical picture: prolactin 375...

We present the case history of a 33-year-old male with Noonan syndrome diagnosed at 2 months of age, as he had typical facial features (hypertelorism, ptosis, low set ears, and small pointed chin), a heart murmur and bilateral cryptorchidism. At 22 months he underwent patent ductus arteriosus closure and at 24 months, the left testis was excised, for testicular torsion. He had learning difficulties and attended a special needs school and was intermittently reviewed in the paed...

Male hypogonadism is usually considered in the presence of classical symptoms like reduced libido, erectile dysfunction and reduced bone mineral density.We present the case history of a 43-year-old man with learning difficulties who presented with long-standing lethargy. Clinical examination revealed bilateral ptosis, muscle weakness and slow relaxation of handgrip. He had abdominal obesity, pseudo-gynaecomastia, frontal balding, reduced facial, chest, a...