Endocrine Abstracts

The Insulin tolerance test (ITT) is regarded as the gold-standard for diagnosing ACTH deficiency but some normal subjects do not exhibit an adequate cortisol response to hypoglycaemia. Identification of false fail cases in pituitary patients is important so as to avoid unnecessary treatment with glucocorticoids. Two hundred consecutive ITTs in pituitary patients were analysed. Twenty six (13 males) failed the ITT and subsequently have a Short Synacthen test (SST). 20 patients ...

Background: Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) also known as Hashimoto’s encephalopathy (HE), is a rare immune-mediated complication independent of functional status of thyroid, which leads to either stroke-like symptoms, or presents as diffuse progressive symptoms of altered mental status, seizures, and cognitive dysfunction. Here we present a case of SREAT in a female with recurrent episodes.Case histo...

Hyperparathyroidism occurs in most patients with MEN Type 1 but the association of MEN type-1 with parathyroid carcinoma has only been described previously in one patient. In this report, we describe two further cases of parathyroid carcinoma presenting in association of MEN type 1 syndrome.The first patient was a 69-year-old woman who presented with severe hyperparathyroidism and tracheal compression by a mediastinal mass which was shown histologically ...

Anterior pituitary dysfunction is a well-recognized complication of traumatic brain injury (TBI) but recovery is an exceptional event, with only three previously published case reports.We report a case of a 25 year old man who suffered severe TBI in a road traffic accident in 1997. His neurological recovery was slow and incomplete with significant cognitive deficit and recurrent seizures. He developed polyphagia and his weight increased by 20 Kilograms i...

There is little information on the effects on pituitary function of cranial irradiation for non-pituitary tumours. We have studied anterior and posterior pituitary function in 17 patients (6 males), with a median age 19 years (range 5-48) at the time of radiotherapy. 16 patients had primary brain tumours and one had acute lymphocytic leukaemia. The patients were selected by the radiotherapists for investigation . Pituitary functions were assessed at a median of 60 months (rang...

Case presentation: A 35-year-old man presented to the emergency department (ED) in a confused and agitated state. His past medical history was significant for poorly controlled type 1 diabetes, complicated by background diabetic retinopathy. He was taking basal/bolus insulin and had a history of diabetic ketoacidosis (DKA) eleven years prior. He also had multiple sclerosis however disengaged with neurology services and was non-compliant with interferon therapy. Prior to admiss...

Case presentation: A 35-year-old man presented to the emergency department (ED) in a confused and agitated state. His past medical history was significant for poorly controlled type 1 diabetes, complicated by background diabetic retinopathy. He was taking basal/bolus insulin and had a history of diabetic ketoacidosis (DKA) eleven years prior. He also had multiple sclerosis however disengaged with neurology services and was non-compliant with interferon therapy. Prior to admiss...

Introduction: The mutation at m. 3243 adenine to guanine (A>G) in mitochondrial encoded transfer-RNA Leucine 1 (MTTL1) gene is the single most prevalent disease-causing mitochondrial DNA (MtDNA) mutation, with carrier status of 1:400 in our general population. The distinct disease phenotype is dependent on the level of heteroplasmy of wild-type vs mutation-type mtDNA in the specific target tissues, ranging from Maternally inherited diabetes and Deafness (MIDD) to mitochond...

Background: Insulinoma in a pre existing patient of type diabetes is extremely rare presentation.Methods: We are presenting a a rare case of insulinoma in a pre existing case of type 2 diabetes. A 73 years old patient with type 2 diabetes for 35 years presented to endocrine clinic with hypoglycaemic symptoms ultimatley diagnosed with insulinoma and patient developed renal failure with diazoxide treatment.Result: A 73 years old chin...

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...