Endocrine Abstracts

We present a case of a 53 year-old lady with HIV, who was referred to the endocrine service with a random cortisol of <20 nmol/l. She complained of fatigue, appetite loss and 13 kg weight loss. She had a history of brain histoplasmosis, which had been successfully treated >5 years previously. At that time she required a short course of steroid therapy acutely. Short synachthen test revealed inadequate response (cortisol at 0 min: 378 nmol/l, 30 min: 481 nmol/l, 60 min:...

25% of Cushing’s syndrome cases are caused by cortisol producing tumours of the adrenal glands. Adrenalectomy is standard treatment followed by glucocorticoid replacement therapy until the hypothalamic-pituitary-adrenal axis recovers. We present a challenging case of adrenal insufficiency after unilateral adrenalectomy for Cushing’s syndrome. A 38 year-old woman was referred with hyperlipidaemia and uncontrolled hypertension diagnosed 4 years previously. Examination ...

A 33 year-old-lady presented to the emergency department with acute abdominal pain and per vaginal bleeding. Her last menstrual period was six weeks prior to admission. She had a positive urine pregnancy test and a trans-vaginal ultrasound confirming an ectopic tubal pregnancy. She underwent an emergency laparoscopic right salpingectomy under general anaesthesia with blood loss intra-operatively of 300 ml. One day post-op, her haemoglobin dropped from 129 g/l to 86 g/l. She re...

Leiomyosarcoma is a rare, malignant tumour that can arise from smooth muscle cells anywhere in the body; common sites include uterus, GI tract and retroperitoneum. We report an unusual case of a patient with an adrenal incidentaloma confirmed as a leiomyosarcoma on histology.A 61-year-old Caucasian female was investigated for chronic abdominal pain. CT scan of the abdomen and pelvis did not show any pathology other than an inci...

We report the case of an 82-year-old lady who was admitted with hypercalaemic crisis (adjusted Calcium 4.82 mmol/L) and acute kidney injury (creatinine 169 micromol/L). PTH was 295 pmol/L, raising the suspicion of an underlying parathyroid carcinoma. She had no palpable neck mass. Her ALP was 131 IU/L and Vitamin D 73 nmol/L; myeloma screen was negative and chest radiograph showed no pathology. A DEXA scan revealed osteoporosis. The hypercalcaemic crisis...

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...

Leiomyosarcoma is a rare, malignant tumour that can arise from smooth muscle cells anywhere in the body; common sites include uterus, GI tract and retroperitoneum. We report an unusual case of a patient with an adrenal incidentaloma confirmed as a leiomyosarcoma on histology.A 61-year-old Caucasian female was investigated for chronic abdominal pain. CT scan of the abdomen and pelvis did not show any pathology other than an inci...

We report the case of an 82-year-old lady who was admitted with hypercalaemic crisis (adjusted Calcium 4.82 mmol/L) and acute kidney injury (creatinine 169 micromol/L). PTH was 295 pmol/L, raising the suspicion of an underlying parathyroid carcinoma. She had no palpable neck mass. Her ALP was 131 IU/L and Vitamin D 73 nmol/L; myeloma screen was negative and chest radiograph showed no pathology. A DEXA scan revealed osteoporosis. The hypercalcaemic crisis...

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...