Endocrine Abstracts

Introduction: Pre-operative localization of parathyroid adenoma is generally done by two localization studies: ultrasonography (US) and parathyroid scintigraphy using 99 m-techentium sestamibi SPECT with CT (Tc-MIBI SPECT/CT), which also report on Incidental thyroid nodules. The aim of our retrospective study was to determine the incidence, characteristics and outcomes of these incidental thyroid findings during parathyroid imaging.Method: A database of ...

Background: Hypogonadism and erectile dysfunction have diverse causes. Hypogonadotrophic hypogonadism results from pituitary dysfunction, often caused by pituitary adenoma, pituitary surgery, radiotherapy, or use of prescription/non-prescription drugs. Rarer causes should be considered during initial investigation of patients with erectile dysfunction. We present a case of secondary hypogonadism and how further investigations eventually led to the underlying diagnosis.<p c...

Background: Adult spontaneous hypoglycaemia in non-diabetic patients is not a diagnosis per se but a manifestation of a disease and is often a diagnostic challenge. Although rare, it’s important to exclude endogenous hyperinsulinemia, because treatment can be curative. The aim of our audit was to assess the usefulness of various investigations done for spontaneous hypoglycaemia in diagnosing Insulinoma.Methods: Data on 98 non-diabetic patie...

Introduction: Benign prostatic hypertrophy is common amongst elderly men, and usually treated with the testosterone blocker, finasteride. However, the treatment of such a condition alongside hypo-pituitarism and low testosterone levels presents with a therapeutic dilemma.Case report: An 88-year-old gentleman who was admitted following recurrent episodes of confusion and falls was found to have a serum sodium level of 114 mmol/l, serum osmolality of 258 m...

Introduction: Cerebral ischaemic events in young patients due to patent foramen ovale are rare. A more plausible diagnosis had clouded the initial management and diagnosis of such a case in a young male patient.Case report: A 19-year-old gentleman was admitted with vomiting and profound hyponatraemia of 99 mmol/l. He was diagnosed to have Addison’s disease (with positive adrenal antibodies) following a flat short synacthen test. He warranted ITU adm...

Introduction: Acromegaly is a rare, progressive disease characterised by excess growth hormone. The recommended treatment is surgery. Radiotherapy and somatostatin analogues are used as adjuncts. The risk of post-radiotherapy osteosarcoma is 0.01% to 0.03% among all irradiated patients. We report a case of radiation-induced osteosarcoma that developed 22 years after radiotherapy for acromegaly.Case report: In 1997, a 53-year-old gentleman with acromegaly...

Background: Short Synacthen test (SST) is being increasingly used in various clinical conditions, mainly for completion purpose of ruling out adrenocortical insufficiency rather than actively suspecting it (for instance hypothyroidism with tiredness, type 1 diabetes with hypoglycaemia). The aim of our retrospective analysis was to assess if a random cortisol could predict the outcome of SST.Method: Data were collected on all SST done at the endocrine uni...

Proton pump inhibitors (PPI) are widely prescribed. PPI-induced diarrhoea and hypomagnesaemia are well-documented in literature. Hypomagnesaemia is well-known to cause functional hypoparathyroidism. We describe a patient who had transient profound hypoparathyroidism which improved on discontinuing PPI and normalising severe hypomagnesaemia.A 72-year-old male, who was on oral anti-diabetic medications, calcium/vitamin D3 supplements and PPI, presented wit...

Autoimmune encephalitides are being increasingly recognised as important and potentially reversible non-infectious causes of the encephalitic syndrome. Myriad of clinical presentation and lack of symptom specificity leads to a wide differential diagnosis. Failure to diagnose the correct aetiology of an encephalitic syndrome can lead to significant morbidity and mortality. A 57 years old right handed female with no significant medical problems initially presented with left side...

Background: Mullerian agenesis or Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a congenital failure of the Mullerian duct to develop, resulting in complete or partial absence of the cervix, uterus, and vagina. It can be isolated (MRKH type I) or associated with renal, vertebral, and, to a lesser extent, auditory and cardiac defects (MRKH type II). Pituitary disease is not a known association. We report a patient who has isolated MRKH syndrome (MRKH type I) and a pituitary...