Endocrine Abstracts

Case: Acromegaly is associated with osteoarthritis due to soft tissue swelling. Our patient was first diagnosed with acromegaly in 2001 at the age of 51, subsequently undergoing a transsphenoidal pituitary adenoma resection in 2002, followed by postoperative radiotherapy in 2003, with subsequent development of anterior hypopituitarism. He has comorbidities of osteoarthritis, (having previously undergone bilateral total hip replacements and a left total knee replacement), bunio...

A 40 year old lady presented to GP with few months history of palpitation, anxiety, frequent stools in April’15. Clinical examination revealed moderate sized goitre, more prominent on right side, mobile, non-tender and no lymphadenopathy. Blood tests consistent with T3 toxicosis with FT3 10 (3.5–6.5), FT4 21 (9–25), TSH <0.05 (0.3–5.0) and thyroid peroxidase antibody positive at 562 IU/ml (0–60). Initiated on Carbim...

Background: Patients with Phaeochromocytomas (PCC) have been found to carry germline mutations in 40% of cases. The number of known susceptibility genes has risen sharply in recent times, from six to sixteen since 2009. We present a patient who was found to have a mutation in Myc Associated Protein X (MAX), one of the newly identified inherited susceptibility genes.Case Presentation: A 16-year-old female presented with paroxysmal episodes suggestive of c...

Background: Patients with Phaeochromocytomas (PCC) have been found to carry germline mutations in 40% of cases. The number of known susceptibility genes has risen sharply in recent times, from six to sixteen since 2009. We present a patient who was found to have a mutation in Myc Associated Protein X (MAX), one of the newly identified inherited susceptibility genes.Case Presentation: A 16-year-old female presented with paroxysmal episodes suggestive of c...

This case shows the potential unreliability of a single ACTH assay in the context of Cushing’s syndrome and need for better ways of measuring ACTH and precursors. A 35 year-old lady presented with severe abdominal pain and cushingoid features. CT scan showed a 2.9 cm right adrenal nodule. Investigations: 24-hour UFC 446 nmol/l, post-dexamethasone cortisol level of 572 nmol/l. The referring hospital found a suppressed ACTH < 0.1ng/l consistent with ACTH-independent Cus...

Case: A 69 year old gentleman with a past medical history of essential hypertension presented to medical services with symptoms of weight loss, muscle weakness and fatigue. Following blood tests, a CT scan, liver biopsy and biochemical screening, a metastatic phaeochromocytoma was diagnosed. He was commenced on alpha and beta blockade. Further imaging, including a MIBG scan, showed non-resectable disease therefore he underwent therapeutic MIBG treatment. Following a good respo...

Introduction: Polycystic Ovary Syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, with important long term health consequences such as higher chance of developing Type 2 diabetes, reduced overall wellbeing with poor quality of life. Such a common condition is mainly treated and investigated in the primary care setting.We therefore set out to see if the randomized controlled trials (RCT) represent the most common setting of care.<p class="abstex...

Background: Adrenal incidentalomas are classified as adrenal lesions picked up on imaging performed due to reasons other than to look at the adrenals. With cross sectional imaging becoming more frequent, the frequency of adrenal lesions being detected and referred to endocrine services is increasing and dedicated adrenal incidentaloma clinics are being set up to screen these patients for potential pathology.Case: We present a 63 year old lady who underwe...

Background: Knowledge of Cranial Diabetes Insipidus (CDI) is poor amongst healthcare professionals. Intra-nasal Desmopressin sprays are often mistaken for pulmonary inhalers, and Diabetes Insipidus mistaken for Diabetes Mellitus, leading to incorrect management and harm. Correct Desmopressin administration and fluid management is paramount in inpatients, especially in reduced conscious states.Aim: To explore Clinicians’ concerns regarding safety iss...

Case: A 32 year old with known classical 21 hydroxylase deficiency was planning her first pregnancy. She had a history of clitoral reduction and vaginal reconstructive surgery as a baby. Pre-conception control on prednisone and fludrocortisone was good: 17(OH) progesterone 8.3 nmol/l, androstenedione 9.8 nmol/l (0.7–10.8), testosterone 3.0 nmol/l (0.2–3). EUA showed a small vaginal opening and she was given vaginal dilators. She conceived successfully and was counsel...