Endocrine Abstracts

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...

Objective: Amiodarone is an iodine rich, potent antiarrhythmic drug that is highly lipid soluble and total body iodine stores remain increased for up to 9 months. Abnormal thyroid functions, either thyrotoxicosis or hypothyroidism occur in upto 14–18% of patients receiving long-term amiodarone therapy. Hence regular thyroid function tests are required in patients on long-term amiodarone treatment. The BNF clearly states that thyroid function tests should be done at a mini...

Incidentally found adrenal tumour is one of the most frequent adrenal disorders due to increased availability and use of imaging studies. But a well circumscribed, homogenous calcified adrenal incidentaloma are extremely rare.We present a case of 68-year-old women who underwent X-ray chest examination for routine health check up, which revealed hyper intense lesion in left sub diaphragmatic area. Further evaluation by a CT scan abdomen revealed hyper den...

Graves' disease is known to occur with increased frequency in patients with Type 1 diabetes mellitus (T1DM) especially women. Undiagnosed thyrotoxicosis can aggravate glucose intolerance and precipitate diabetic ketosis and ketoacidosis. Among the various presenting symptoms of hyperthyroidism, vomiting is a recognized but uncommon symptom.We present the case history of a 30 year old woman with T1DM of 10 years duration presenting with a short history of...

Most cases of primary hyperparathyroidism are due to either parathyroid adenoma or hyperplasia. Parathyroid carcinoma is a rare cause of hyperparathyroidism, usually diagnosed post operatively .Prognosis is poor with a 5 year survival rate of 50-75%.A 74 year old man presented with a 2 week history of weight loss, anorexia and constipation but no abdominal or bone pain. Past history included hypertension and gout and was not on drugs known to cause hyper...

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...

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...

Background: Thorough history taking and clinical examination is vital in the assessment of all medical patients. However, diagnosis of endocrine disease also relies on appropriate biochemical tests. Previously in our unit, tests were only performed after new patients attended clinic. We proposed that diagnosis and management would be improved if this system was inverted.Method: In 2009 clinicians, nurses and chemical pathology representatives reviewed av...

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...