Endocrine Abstracts

: 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...

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...

Prolactinomas are the most common hormone-secreting pituitary tumors. They typically present with hypogonadism, decreased libido, infertility, and gynaecomastia in men. We present an interesting case of a 44-year-old gentleman who was referred to our endocrine clinic for ‘abnormal thyroid function tests’ with a low T4 despite a normal TSH (TSH 2.01, T4 7.5, T3 3.9). He reported a few years’ history of increasing weight gain and lethargy, generalized aches and pa...

Case history: A 22-year-old female first presented to our endocrine clinic in 2008 with a six-month history of galactorrhoea and irregular menses.Investigations: 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. She had reverse FSH:LH ratio hence the possibility of PCOS was considered. Her pelvic ultrasound did not s...

Hyperglycaemic hyperosmolar state (HHS) is a common medical presentation, typically occurring in older patients with Type 2 diabetes mellitus. Mortality rates have been reported to be up to 60%. Precipitating factors include dehydration, sepsis, cardiovascular disease and drugs. Here, we describe a rare case of HHS, likely to have been precipitated following the development of lithium-induced nephrogenic diabetes insipidus (DI).A 62-year-old female prese...

We present the case of a 35-year-old woman who was well until pregnancy 4y previously in Israel. Her antenatal course was uncomplicated. She breastfed postpartum and a few months into this she experienced acute back pain on reaching for a nappy. MRI demonstrated six vertebral fractures. DEXA scan confirmed osteoporosis (lumbar T-score −4.3, hip T-score −3.3). She received a single dose of denosumab. She moved to the UK 2y later and was referred to our Endocrine Bon...

We present a 52-year-old female with a 26-year history of type-2 diabetes mellitus who has been difficult to treat owing to the development of multiple insulin allergies. She initially developed local hyperpigmentation and itchy swellings at the injection sites of her Humulin I in 2016, with similar symptoms occurring when she was switched to NovoRapid. Additionally, she developed one severe, systemic reaction to Humulin I. All insulin treatment was stopped, and she was left s...

A 22-year-old male presented to the Emergency Department with nausea and vomiting. He reported thirst, polyuria, reduced appetite and weight loss. He did not have pre-existing medical conditions and did not take regular medications. On examination, he appeared pale and clammy. He was apyrexial, tachycardic and tachypnoeic with normal blood pressure and oxygen saturation. His chest was clear and abdomen generally tender. A venous blood gas revealed pH 6.94, base excess −2...

A 70-year-old lady, with a background of primary hypothyroidism presented to the Emergency department with a 1 day history of confusion and drowsiness. On examination her HR was 58 bpm, temperature 28 degrees celsius. She was resuscitated with warm fluids and bair hugger, whilst also given broad spectrum intravenous antibiotics. Her blood results showed an AKI with creatinine of 213 and was treated for a NSTEMI with a troponin on admission of 1770, rising to 2190. ECG showed p...

Case history: A 54-year-old lady was diagnosed with primary hypoparathyroidism in 2005, after being referred by her Rheumatologist as her father and brother had familial hypoparathyroidism and sensorineural deafness. She was followed up in endocrine clinic for management of primary hypoparathyroidism. Her hypocalcaemia is well managed with calcium supplementation, with no specific symptoms of hypocalcaemia. She has recurrent urinary tract infections with known borderline chron...