Endocrine Abstracts

A 31-year-old female presented with menstrual irregularities, weight gain and hirsutism.She was recently diagnosed with type 2 diabetes requiring Metformin therapy.Investigations: Serum cortisol levels failed to suppress on overnight dexamethasone suppression test (ODST) and low dose dexamethasone suppression tests (LDDST) (ODST: unsuppressed cortisol at 343 nmol/l, LDDST 48 h post dexamethasone cortisol of 397 nmol/l). The serum c...

Introduction: Neuroendocrine tumors (NET) are very rare and often present a diagnostic challenge. They are often misdiagnosed due to non-specific symptoms. We report a rare case of NET presenting to a non endocrine unit.Case: A 72-year-old Caucasian female was referred for refractory diarrhoea with hypokalaemia. In addition, there was history of significant weight loss over few months.She had past medical history of diabetes, hyper...

We studied the practice of investigations for diagnosing and localising insulinoma in our hospital. We looked at the number of investigations performed before exact localisation of insulinoma.We identified 5 cases that were confirmed on clinical, biochemical or histopathological bases and were recorded on the histopathology and IT database as ‘insulinoma’ from 1986 to 2004. We looked retrospectively at the case notes of these cases.<p class...

Background: We report a case of a 35-year-old male presenting with pituitary dysfunction secondary to an optochiasmal cavernoma.The gentleman was initially referred with gynaecomastia and biochemical tests consistent with secondary hypogonadism. On further questioning he also reported extremely lethargy, difficulties with weight loss and poor libido. Examination was consistent with features of hypogonadism with reduced body hair, bilateral gynaecomastia ...

Backgound: We report a case of a 63-year-old postmenopausal female diagnosed with ovarian hyperthecosis masked by concurrent use of an aromatase inhibitor.Following diagnosis of breast cancer in 2009, requiring mastectomy with adjunctive chemotherapy, she was commenced on anastrozole. Later she noted gradual onset of frontal balding and hirsutism. Biochemistry revealed elevated serum levels of testosterone 13.2 nmol/l (range: <1.9 nmol/l) and androst...

Background: We report a case of a 51-year-old man with functioning cardiac paraganglioma diagnosed subsequent to a primary coronary event. Following a myocardial infarction aged 39; he was incidentally found to have a cardiac tumour in the pericardial sac. This was assumed to be benign and followed up with serial imaging. Recent scans suggested a possible paraganglioma with evidence of very slow tumour growth leading to an endocrinology referral. On further questioning he did ...

Neuroendocrine tumors (NETs) are rare tumours arising from the gastroenteropancreatic axis. They are slow growing and often metastatic. Diagnostic workup requires imaging; both anatomical (ultrasound, CT, MRI) and functional (somatostatin receptor scintigraphy, PET).NETs strongly express somatostatin receptors (SSTRs) of five different subtypes (SSTRs1–5) with SSTR2 being the most common. Some NETs reflect hyperactivity of the guanethidine pathway. ...

A 28-year-man originally from Africa presented with short stature. His height at first clinic visit was 128 cm and there was no family history of short stature. He had pale complexion, lack of facial/body hair and under-developed secondary sexual characteristics consistent with morphology of hypopituitaric dwarfism. Insulin stress test with adequate hypoglycaemia<2.2 mmol/l confirmed flat growth hormone (GH) response (peak <0.5 mU/l) and inadequate cortisol response (p...

Introduction: Adult Growth Hormone Deficiency (AGHD) is associated with osteoporosis. Underlying mechanisms involved in the pathogenesis include reduced target-organ sensitivity to the effect of PTH. Growth Hormone Replacement (GHR) in AGHD leads to increased PTH target-organ sensitivity and consequently increased bone turnover and bone mineral density (BMD).Aims: We determined the effect of alendronate, given in addition to GHR, on PTH target-organ sens...

Background: Circulating levels of total oestradiol (E2) decrease with age in adult males; the effect of altered E2 circadian rhythm is uncertain. We hypothesised that age-related changes in the circadian rhythm contribute to decreased BMD in older males and investigated this.Methods: Nineteen subjects were studied: six young-healthy (YH) males (mean age (years) 27.3±4.6) with normal BMD, eight older-healthy (OH) males (mean age...