Endocrine Abstracts

This 60-year-old male was reviewed remotely for follow up in the general endocrine outpatient clinic having originally been referred for erectile dysfunction and low libido. He had a past medical history of hypertension and dyslipidaemia and was prescribed amlodipine and atorvastatin. On previous clinical assessments, he had increased muscle bulk, normal secondary sexual characteristics with testes measuring 15mls and 12mls. There had been no evidence of gynaecomastia. He work...

This female patient presented acutely with headache and neck pain associated with vomiting. Neurological examination was normal. Urine pregnancy test prior to imaging was unexpectedly positive. CT head demonstrated a 2.5x1.5 cm hyperattenuating lesion at the left frontoparietal region. Thyroid function tests were in keeping with thyrotoxicosis (TSH <0.01 mU/l, free T4 37.2 pmo/l, free T3 >30.7 pmo/l). Antithyroid medication was commenced and TSH receptor antibody reque...

This 31 year old patient was referred to the endocrinology department with a history of dizziness and fatigue. Past medical history identified that he had been diagnosed with congenital adrenal hyperplasia, presumed to be secondary to 21-hydroxylase deficiency, by 18 months of age whilst living abroad. He had been raised as a male but was found to have 46XX genotype with grade 5 virilisation. During childhood and early adolescence, he underwent multiple operations to remove Mu...

Anabolic androgenic steroids (AAS) are class C drugs with adverse effects on health. Prevalence is increasing, often with a lack of awareness of the dangers. We present the case of a 33 year-old male with dilated cardiomyopathy and polycythaemia apparently due to AAS abuse over three years. The patient presented with five weeks of increasing breathlessness and chest tightness. Examination revealed evidence of congestive cardiac failure. Chest radiograph showed evidence of pulm...

Background: We previously reported that a high number of synacthen tests are carried inaccurately within our trust with a significant delay in sample collection after tetracosactide injection. We also reported a high number of patients having Synacthen tests unnecessarily. In light of this we introduced a Synacthen proforma and re-audited our results.Method: A retrospective study was carried out on 36 patients undergoing Synacthen tests bet...

Background: We previously reported that a high number of synacthen tests are carried inaccurately within our trust with a significant delay in sample collection after tetracosactide injection. We also reported a high number of patients having Synacthen tests unnecessarily. In light of this we introduced a Synacthen proforma and re-audited our results.Method: A retrospective study was carried out on 36 patients undergoing Synacthen tests bet...

Peripartum hyponatraemia is an under-recognised complication of labour and poses a risk to both mother and baby. It is typically caused by water intoxication for physiological reasons and population health trends around water intake. We have recent experience of managing 2 patients with severe symptomatic hyponatraemia. Both patients had increased their oral intake of fluid during labour as well as receiving intravenous fluids. Dilutional hyponatraemia was found to be the unde...

Background: Genetic causes of hypocalcaemia can be overlooked in patients presenting without apparent syndromic features. One such example is DiGeorge syndrome, which is often diagnosed in childhood but rarely in adulthood.Case presentation: A 21-year-old lady was referred to our endocrinology clinic regarding chronic hypocalcaemia (adjusted calcium 1.98 mmol/l). This was first diagnosed at the age of eight with no clear cause identified. Her past medica...

A 41-year-old woman with primary ovarian failure secondary to Turner syndrome presented in December 2020 with heavy vaginal bleeding. She had not attended appointments during the Covid-19 epidemic because of concerns around contracting the virus. She was anaemic with haemoglobin 47g/dl. Ultrasound showed grossly thickened and heterogenous endometrium (60 mm). Cross sectional imaging and hysteroscopy confirmed locally advanced endometrial carcinoma (Stage 3). She proceeded to h...

Background: Pituitary apoplexy is one of the rare endocrine emergencies. Most series indicate that incidence is between 2-7% based on clinical, surgical and histopathological evidence.1-3 Usually presents with severe headaches that may be associated with nausea vomiting, ocular palsies, fever, photophobia. Predisposing factors are pre-existing pituitary conditions, hypertension, major surgery, anticoagulation therapy, pregnancy, radiotherapy. Appropriate endocrine, ...