Endocrine Abstracts

A 45-year-old lady presented to her GP with sweating, poor memory, and decreased, concentration. Investigations revealed elevated oestradiol at 2204 pmol/l, LH at 28.1 IU/l, and FSH at 15.0 IU/l. This raised the possibility of a Gonadotrophinoma. A preclinic pituitary MRI showed a subtle rounded nodule of tissue within the right side of the anterior pituitary. In clinic, she revealed that she was consuming aloe vera juice for several years to improve her skin and general well-...

Hyperthyroidism commonly affects women of child-bearing age. Use of carbimazole in the first trimester of pregnancy has been shown to be associated with certain congenital abnormalities, such as aplasia cutis, choanal atresia, dysmorphic facial features, abdominal wall and gastrointestinal tract defects, in up to 2% of cases. The MHRA issued a Drug Safety Alert in February 2019, recommending to strengthen the advice on contraception given to women of child-bearing age who need...

Ectopic Cushing's syndrome is rare, accounting for 5–10% of all cases of Cushing's. The majority are casued by small cell lung cancer and neuroendocrine tumours.We report a case of a 59 year old male who presented with osmotic symptoms after newly diagnosed diabetes, hypokalaemia and metabolic alkalosis with clinical features suggestive of Cushing's. Initial random cortisol was >2000 nmol/l and 24 hour urin...

Ectopic Cushing's syndrome is rare, accounting for 5–10% of all cases of Cushing's. The majority are casued by small cell lung cancer and neuroendocrine tumours.We report a case of a 59 year old male who presented with osmotic symptoms after newly diagnosed diabetes, hypokalaemia and metabolic alkalosis with clinical features suggestive of Cushing's. Initial random cortisol was >2000 nmol/l and 24 hour urin...

A 32 year old Polish gentleman presented following a collapse with preserved consciousness. Preceding this he was noted to have had a rapid deterioration in mobility with worsening weakness in all four limbs. On further questioning the patient had been diagnosed with hyperthyroidism two months previously and was being treated with propylthiouracil. Positive examination findings included tachycardia with upper limb weakness with 2/5 power bilaterally and lower limbs weakness wi...

Transient mild hyperthyroidism is fairly common in women with hyperemesis gravidarum, occurring in up to two-thirds of them. It is also a well known fact that pregnant women with severe hyperemesis gravidarum can progress to develop Wernicke’s encephalopathy. Hyperthyroidism, without any other risk factors, has been described to accelerate the process of thiamine depletion as well. This is much less recognised.We describe the case of a 32-year-old P...

An 87 year old gentleman with type 2 diabetes mellitus was started on oral sodium fusidate for infected left middle toe ulcer. His blood test revealed Sodium 140 mmol/L, potassium 5.2 mmol/L, urea 25.3 mmol/L, creatinine 287 µmol/L, eGFR-19 ml/minute, albumin 29 g/L, adjusted calcium 2.17 mmol/L, and phosphate 0.95 mmol/L. Two days later he was admitted to hospital. Blood tests on admission showed severe hypocalcaemia with renal failure. (Sodium 146 mmol/LL, potassium 4.9...

Hypercalcaemia is a rare, albeit well-described feature of hypoadrenalism, although the mechanism underlying this is remains controversial. Primary adrenal failure is known to occur secondary to infective agents, and indeed tuberculous infiltration of adrenal tissue represents one of the leading aetiologies worldwide. Primary adrenal failure has also been shown to occur secondary to sepsis with Meningococcus or Pseudomonas species, but classically this presents w...

A 23-year-old man initially presented to his GP with palpable ‘gland in his neck’ for 9 years. He was otherwise well with no medical problems. He has a family history of hypothyroidism. Examination revealed right submandibular gland enlargement and lymph nodes in the anterior cervical region bilaterally. His TPO antibody was negative and the only abnormal result was a raised TSH of 12.7. He was commenced on 50 μg of thyroxine daily. Ultrasound of the neck showed...

Adrenoleukodystrophy (ALD) is an X-linked, widely heterogeneous, neurodegenerative disorder of peroxisomal metabolism characterised by the accumulation of very-long-chain fatty acids (VLCFA). A mutation in the ABCD1 gene is responsible. ALD has both a neurological and an endocrine interface as VLCFA deposit in the central and peripheral nervous system as well as the adrenal cortex and testis. ALD can present in childhood with a cerebral form or later in life as an adrenomyelon...