Endocrine Abstracts

A 33-year-old woman who was 38-weeks pregnant was referred to our Endocrine team for bilateral temporal hemianopia. Her past medical history includes juvenile myoclonic epilepsy, for which she takes lamotrigine 275mg BD. She was reviewed by the Endocrinologist in 2018 for polyuria and nocturia which were attributed to the introduction of antiepileptics (normal pituitary biochemistry and MR pituitary). Her symptoms subsequently improved. Current symptoms started with acute retr...

We present a 38-year-old patient who had adrenal insufficiency following laparoscopic removal of 3.2 cm cortisol-secreting right adrenal tumour. His biopsy showed adrenocortical adenoma in keeping with Cushing’s syndrome. He had a history of hypertension with suboptimal control despite being on 3 anti-hypertensives. His early morning cortisol (by GP to investigate secondary causes) were elevated and this prompted Endocrine referral. Clinical history and examination were ...

A fit and well 41-year-old lady who was 10-days post-partum was referred to our Endocrine team for hyponatraemia (serum sodium 117 mmol/l). She had a spontaneous vaginal delivery but had 1.5L blood loss due to difficulty with placenta removal. Her baby is well with no medical issues. During pregnancy, she was started on aspirin due to maternal age and had diet-controlled gestational diabetes. She presented to hospital with extreme lethargy. She also reported lightheadedness a...

Background: Familial dysalbuminaemic hyperthyroxinaemia (FDH) is an interesting autosomal dominant condition that is associated with euthyroid hyperthyroxinaemia, whereby patients remain euthyroid but laboratory value will show high free thyroxine (fT4) level. It is caused by mutations in ALB (albumin) gene that increase affinity of albumin for thyroxine (T4). The usual thyroid assay will show a spuriously high level of thyroxine. This interferen...

Background: Haemoglobinopathies are inherited disorders of haemoglobin that predispose to endocrinopathies. The common ones include growth delay, hypogonadism and subsequent osteopaenia. Less commonly seen are diabetes mellitus, thyroid and adrenal disorders. Aetiology is multifactorial and includes tissue hypoxia, chronic anaemia, iron overload, high energy demand, genetic influence and malnourishment. We present three case reports which illustrate the endocrinopathies amongs...

Background: Managing mental health patients with Diabetes Mellitus can be challenging. Patients with mental health problems are poorly compliant with both antipsychotic and diabetes treatment. Literature has suggested that some psychiatric illnesses can be independent risk factors for diabetes. Furthermore, diabetic patients have a higher incidence of psychiatric disorders. There is a causal relationship between newer antipsychotic medications and metabolic abnormalities.<...

A 51-year-old gentleman presented in June 2022 with pneumobilia, staph liver abscesses and rapidly conducted atrial fibrillation requiring ITU admission. He had a 2-year history of typical Cushingoid features and hypogonadism, 4 agent hypertension since 2012, fragility fractures, previous renal calculi, pulmonary emboli and diabetes. He had not been able to walk unaided for a year (was mobilising with crutches on admission). In retrospect, he had previously had a cortisol of 7...

A 35-year-old gentleman was referred to our Endocrinology department by Moorfields Eye hospital. He reported a one-year history of visual decline in his right eye, which led to prescription glasses, and incidental finding of bilateral conjunctival nodules. He had reduced visual acuity (pinhole right eye: 6/24 and left eye 6/6) and prominent corneal nerves on slit-lamp examination. He underwent an excisional biopsy of the conjunctival nodules confirming bilateral conjunctival n...

Introduction: Hypoglycaemia is an endocrine and medical emergency. It is usually due to the excessive dose of insulin or oral anti-diabetic agents. Although rare, hypoglycaemia can be a tumour–induced. Some of the other causes include renal and liver failure, hormonal deficiency, antibodies to insulin, infection, starvation, spontaneous hypoglycaemia and reactive hypoglycaemia.Case report: A 70-year-old man presented with 6 months’ history of r...

Introduction: Pituitary apoplexy is both an endocrine and a neurosurgical emergency, and can typically present with sudden onset of headaches, impaired level of consciousness, fever, visual disturbances, nausea or vomiting. Apoplexy ensues when pre-existing pituitary tumour presumably outgrows its blood supply leading to ischaemia, necrosis and haemorrhage or infarction.Case: A 31-year-old man presented to the hospital with 3 months’ history of grad...