Endocrine Abstracts

Incidentally discovered adrenal masses on abdominal imaging for unrelated reasons have a prevalence of 1-7%. A great majority of these are non-functioning adenomas, but 5-30% are associated with autonomous cortisol secretion (ACS), which is mainly subclinical, and 1-5% with phaeochromocytoma or Conn’s syndrome. Here we report two cases of overt functioning adrenal adenoma with coexisting ACS. We could not find any other reports of such cases in the literature.<p class...

Case History: A 70-year-old man of Chinese origin presents with a two-month history of worsening visual acuity and double vision. He denied systemic symptoms apart from marginal weight loss. Other medical history includes stable asthma, treated with inhalers. He has a niece and nephew with thyroid disease. He is an ex-smoker, retired accountant, and drinks occasional alcohol. On examination, he was normotensive with a body mass index of 22 kg/m2 however was found to...

Introduction: Hypothalamic obesity can be associated with multiple co-morbidie and is difficult to treatment\. There is little evidence regarding the effectiveness of currently available treatment for weight loss. We looked at the role of bariatric surgery on weight loss in patients with hypothalamic obesity at St George’s Hospital, London.Methods: Six patients with hypothalamic obesity had bariatric surgery. All patients had associated endocrine de...

Background: Oestrogen replacement therapy is essential in transwomen for their well-being. Various forms of oestrogen therapy are available. Individual responses to such replacement therapy may vary. Hormonal implant is a reliable form of hormone replacement in postmenopausal women. However, their efficacy and safety in transwomen have not been thoroughly examined yet.Methods: 14 transwomen had 100 mg of oestradiol implant inserted subcutaneously in the ...

Background: Various forms of testosterone replacement therapy has been used in replacement therapy for transmen and men with hypogonadism. However, efficacy and safety of testosterone implant has not been studied yet.Methods: 11 patietns (five transmen and six men with hypogonadism) had 800–1000 mg of testosterone implant inserted subcutaneously in the anterior abdominal wall. All subjects had previously been on other forms of testosterone replaceme...

Introduction: Hypothyroidism is a well-recognised cause of macrocytosis, but microcytosis is not widely recognised to be associated with hyperthyroidism. Thyroid abnormalities are often associated with various haematological changes and Graves’ disease has been reported to be mimicking beta thalassaemia trait in the literature. We discuss two cases of microcytosis related to hyperthyroidism that fully resolved once euthyroidism was achieved.Case 1: ...

Introduction: Anterior pituitary cells are characterised by functional lineages based on the expression pattern of transcription factors. Functional differentiation in the form of pituitary adenomas co-secreting ACTH and growth hormone is very rare. We report a case of multiple cell line pituitary adenoma resulting in acromegaly and ACTH dependent Cushing’s.Case: A 52-year-old woman of Ghanian origin (BMI of 57.5 kg/m2) presented with pro...

Introduction:: The hypothalamus is intimately involved in weight homeostasis. Pituitary tumours and treatment for pituitary tumours has been well described to induce obesity in certain subjects presumably due hypothalamic irritation or dysfunction. This is often very challenging to treat.GLP-1 analogues have direct central effects and have been shown to be effective for weight loss in obese patients with and without diabetes mellitus.<p class="abstex...

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...