Endocrine Abstracts

Case History: 16-year-old fit and well lady was referred to endocrinology clinic by GP due to severe hypercalcaemia. She is being investigated for secondary amenorrhea. She is not taking any regular medication. There is a history of hypercalcaemia in the family, her mother has hypercalcaemia and paternal grandfather had hypercalcaemia. She had no signs and symptoms of hypercalcaemia.Investigations: Corrected Calcium: 3.28 mmol/l, Phosphate: 0.60 mmol/l, ...

Hirsutism is one of the most common clinical features encountered in women attending endocrine clinics. It can also be extraordinarily difficult and challenging to manage well. In this brief presentation I will discuss management of hirsutism, using three major challenges as a scaffold:Challenge 1: diagnosing the underlying cause: Hirsutism, the presence of terminal hairs distributed in a male-like pattern in women, affects between 5 and 10% of women. Po...

Sunitinib and sorafenib are orally active tyrosine kinase inhibitors which have recently been developed as therapy for renal cell cancer and gastro-intestinal stromal tumours. Changes in thyroid function are frequently found during sunitinib therapy, typically occurring 7–24 months into therapy; the mechanism is not clear, though inhibition of iodine uptake, thyroid follicular cell apoptosis and thyroiditis have all been proposed. In contrast, thyroid dysfunction is repor...

Introduction: There is growing real-world experience of the SGLT2 inhibitor class for type 2 diabetes mellitus (T2D). We performed an audit of clinico-biochemical effects of SGLT2 inhibitor use for patients with diabesity in the context of a tier-3 obesity service within a UK-based teaching hospital.Methods: We included patients with a confirmed diagnosis of T2D who had been treated with an SGLT2 inhibitor within licensed indications (monotherapy and add...

The importance of weight reduction in the management of diabesity is well-established. However, significant weight loss can be difficult to achieve without bariatric surgery, even within specialist tier 3 obesity services. Here we describe the case of a 52 year old man who presented to weight management clinic. He had made multiple weight loss attempts, but with little success. On presentation, his weight was 140.8 kg with a BMI of 40.3 kg/m2, and he had now been static at thi...

Hypothalamic GnRH neuronal dysfunction is a frequent cause of hypogonadotrophic hypogonadism (HH) in women with secondary amenohrroea. However, the entity is poorly characterized in men, possibly due to lack of a sensitive equivalent clinical marker of the condition.A 40-year-old man presented with a 7-year history of progressive lack of energy, loss of libido, decreased sexual function, and loss of morning erections. Puberty had occurred normally and h...

Introduction: Prostate carcinoma is a recognised yet rare cause of Cushing’s syndrome. This report describes two cases in which Cushing’s syndrome was associated with advanced prostate cancer.Case 1: A 70-year man presented with a very short history of swelling of his face and legs. He was known to have prostate adenocarcinoma with bony metastases. He was hypokalaemic and resistant to standard potassium replacement. He had a Cushingoid appearan...

We report the case of a 53 year old woman with a history of refractory focal epilepsy with complex partial and secondary generalised seizures. She has been on multiple anti-epileptic drugs since childhood. At 42 years of age she was referred to the Endocrinology Department complaining of capital hair loss and hirsutism. At this time her epilepsy was controlled on phenytoin and carbamazepine.A diagnosis of congenital adrenal hyperplasia (CAH) was made, wi...

A32 year old lady was admitted with symptoms of palpitations, tremors, insomnia, heat intolerance, weight loss and excessive perspiration for 4 weeks. Worsening of these symptoms with vomiting prompted the admission. She had similar episode 7 yrs ago following the birth of her child when a provisional diagnosis of postpartum thyrotoxicosis was made but lost follow up with in 2 weeks. She works as a carer looking after mentally handicapped children. Her mother suffers from hypo...

Background: Observational and genetic Mendelian randomisation (MR) data has demonstrated the association of adulthood overweight/obesity with development of polycystic ovary syndrome (PCOS). However, the contribution of early life (i.e. childhood/adolescence) body composition on incident PCOS is unclear. This study determines the influence of body composition on the likelihood of developing PCOS.Methods: We conducted a 2-sample Mendelian randomisation st...