Endocrine Abstracts

Introduction: Paediatric Cushing’s disease is rare and up to 50% have incomplete cure.1 Besides hypopituitarism growth failure is particularly common and maybe due to GH deficiency, target tissue resistance2 or accelerated skeletal maturation 3. Our patient is an 18-year-old obese male who first presented at the age of 16 with delayed puberty and short stature.Results: His 24 hr urinary cortisol was 1472 nmol/l, ACTH...

The causes of panhypopituitarism are well known and pituitary metastases is a recognised but rare cause. It can often be difficult to diagnose because the non-specific features of malignancy mask those of pituitary involvement.We present the case of a 73 year old gentleman who complained of fatigue and weight loss. He had recently been treated for a radiographically proven bronchopneumonia. Endocrine checks suggested secondary hypothyroidism however (TSH...

BackgroundIdiopathic Addisons disease is characterised by the presence of adrenal antibodies and a documented variable subclinical period. In previously well controlled Type 1 diabetes, it may present with recurrent hypoglycaemia, or worsening erratic glycaemic control.Case ReportA 24 year old with previously well controlled Type 1 diabetes since age 18 months presented with worsening glycaemic control, 2 sto...

BackgroundIdiopathic Addisons disease is characterised by the presence of adrenal antibodies and a documented variable subclinical period. In previously well controlled Type 1 diabetes, it may present with recurrent hypoglycaemia, or worsening erratic glycaemic control.Case ReportA 24 year old with previously well controlled Type 1 diabetes since age 18 months presented with worsening glycaemic control, 2 sto...

Recognition of male adult onset hypogonadotrophic hypogonadism (HH) is important in identifying treatable forms of infertility, erectile dysfunction and osteoporosis.There are currently no evidence-based guidelines for diagnosing and treating HH.We evaluated the assessment, diagnosis, treatment strategies and outcome in adult men with suspected HH seen in our endocrine clinic over 1 year. We aimed to evaluate the usefulness of pitu...

Introduction: Adrenal masses may be found as incidental features during abdominal imaging investigations, raising questions as to the need to investigate these lesions for endocrine function or malignancy. This audit utilised published articles and consensus papers to compare our current approach with reported practice in other centres.Method: A retrospective review of the case notes of 21 patients referred to the Endocrine service in the Trust from Nove...

A 27-year-old woman presented with a 6-week history of weight loss, excessive thirst, nocturia and lethargy. She had no significant past medical or family history. At presentation she was unwell, tachycardic and had a blood pressure of 174/100 mm Hg. Physical examination was otherwise unremarkable. Her urine dipstick was strongly positive for glucose and ketones. The plasma glucose was 21.7 mmols/l. An arterial blood gas showed a pH of 7.35 and bicarbonates of 23. She was trea...

A 31 year old woman presented to the emergency department after 3 days of diarrhoea and vomiting. She was 18 months post partum and had lost 19 kg in two months. She described sweats, tremor and palpitations which had been attributed to recent emotional stress. There was no history of ingestion of iodinous compounds or family history of thyroid dysfunction. On examination the patient was tremulous, pale, cachexic, and tachycardic. There was a smooth goitre with no retrosternal...

A 72-year-old man presented with a two-year history of hot sweats, impotence and mood swings. He had a past medical history of polymyalgia rheumatica, osteoporosis and mild hypercalcaemia.On examination he was sweating excessively, had testicular atrophy and mild hypertension. Blood tests revealed a raised LH, FSH and a low testosterone consistent with primary hypogonadism. Hypercalcaemic screen was negative. He was started on androgen replacement therapy as well as anti-h...

A 73-year-old woman presented with hypoglycaemic collapse and a capillary blood sugar of 0.7 mmol/l and required continuous intravenous dextrose to maintain euglycaemia. There was two-week history of night sweats and overnight snacking. One year previous, the patient had been diagnosed with a gastric adenocarcinoma and had undergone a sub-total gastrectomy and chemo-radiotherapy. Physical examination was unremarkable. Liver function was normal except an elevated alkaline phosp...