Endocrine Abstracts

Here we present two interesting cases of pheochromocytoma with unusual presentation. Case1: A 61-year-old gentleman presented with syncope after noticing small amount of haematuria. His initial working diagnosis was vasovagal syncope but on further exploration, he reported previous history of palpitations and atypical chest pain. He was non-smoker with longstanding hypertension. His CT(urogram) showed incidental left adrenal nodule after...

The COVID-19 vaccine plays an important role in managing the pandemic. Unfortunately, there are endocrine side effects also noted. The 36-year-old lady felt unwell 2 weeks post-AstraZeneca COVID-19 vaccine. She got admitted to the hospital after 6weeks with persistent vomiting and significant hyponatremia. She has a past history of well-controlled asthma and hypothyroidism. Random cortisol on admission was 31 nmol/l, and a short synacthen test(SST) confirmed adrenal insufficie...

Background: Immune checkpoint inhibitors are now commonly used in melanoma, renal cell carcinoma and non-small cell lung cancers. Patients on immune check point inhibitors experience at least one type of immune related adverse event(irAEs) which can occur even after discontinuation of therapy. Endocrine toxicities are commonly reported irAE′s and tend to be irreversible. The most frequently recognized endocrine complications include thyroid dysfunction (30%) hypophysitis...

A 50 year-old lady was referred to the endocrine service for evaluation of significantly elevated 3-methoxytyramine (3-MT) levels. Past medical history included well controlled HIV and hypertension controlled by a single agent only (amlodipine). On one occasion, she was noted to have an elevated systolic blood pressure of 189 mmHg in clinic and therefore 24 h urinary metanephrines were requested. She did not have any other symptoms to suggest excess catecholamines. Systems rev...

Objective: Hyperprolactinaemia is one of the most common disorders of the hypothalamic-pituitary axis. Endocrine Society guidelines state that a single prolactin measurement in a blood sample obtained at any time of day is adequate to confirm hyperprolactinaemia. However, prolactin levels can be confounded by physiological stimuli, e.g sleep, stress or exercise. Our objective was to assess the clinical significance of prolactin level obta...

A 43 year old Somali woman presented with increasing fatigue, difficulty getting out of her chair and 15 kg weight gain over a one month. Past medical history included paranoid psychosis, nasal congestion due to adenotonsillarhypertrophy, and human immunodeficiency virus (HIV). Her HIV infection was well controlled (viral load <50RNA copies/ml), with excellent immunological reconstitution (CD4 count >500 cells/mm3). Current medicat...

Hypoparathyroidism following parathyroidectomy is commonly treated with activated vitamin D, (alfacalcidol and calcitriol). Alfacalcidol (1-hydroxyvitamin D) is converted by hepatic 25-hydroxylase to generate calcitriol (1,25-dihydroxyvitamin D) to act on target cells.We present the case of 66 year old man who was admitted with chest pain in November 2016 and found to have corrected calcium of 1.5 mmol/litre and PO4 2.7 mmol/litre....

A 22-year-old female first presented in 2008 with a six-month history of galactorrhoea and irregular menses. She had hyperprolactinaemia (2401 mIU/L), a negative macroprolactin screen and her pituitary MRI scan demonstrated a 4 mm microadenoma. Her cannulated prolactin levels were >1500 mIU/L. TFTs, IGF-1, cortisol and remaining pituitary profile were within normal range.Cabergoline was commenced and gradually i...

: We report a case of a 56-year-old gentleman who presented to the endocrine clinic with erectile dysfunction. He had elevated SHBG levels, MCV, gamma GT, ferritin, iron and markedly elevated testosterone and transferrin saturation (GGT 167 IU/l, ferritin 1128 ug/l, testosterone 62.5 nmol/l). He had a marginally low platelet count (123X109/l). He denied ever taking testosterone supplements. His calculated free testosterone was normal. His full blood count was otherwise unremar...

Objective: Hyperprolactinaemia is one of the most common disorders of the hypothalamic-pituitary axis. Endocrine Society guidelines state that a single prolactin measurement in a blood sample obtained at any time of day is adequate to confirm hyperprolactinaemia. However, prolactin levels can be confounded by physiological stimuli, e.g sleep, stress or exercise. Our objective was to assess the clinical significance of prolactin level obta...