Endocrine Abstracts

We are a presenting a 57 year old male victim of recurrent metastatic melanoma who was treated surgically in 2015 by wide local excision together with right axillary dissection for axillary nodal spread. He re-presented to dermatology clinic in December 2018 with skin lesion that was histologically proven to be a BRAF-mutant malignant melanoma. CT scans at that time showed spread to mediastinal and hilar nodes. Oncology team decided to commence Iplimumab/Nivolumab combination ...

A 25-year-old primi 26 weeks pregnant was admitted with B/L flank pain & pleuritic sounding chest pain. She was septic on initial assessment by the Obstetric team and preliminary investigations revealed high inflammatory markers, raised CRP of 336 & deranged LFT’s. Her USS scan suggested possible hepatitis/cholangitis and blood cultures grew E. coli & she was started on IV Ceftriaxone & metronidazole for the same. At day 3 of her admission, she started det...

It is paramount that any adolescent with a suspected disorder of sex development (DSD) is assessed by an experienced clinician with adequate knowledge about the range of conditions associated with DSD. If there is any doubt, the case should be discussed with the regional team. In most cases, a named endocrinologist within the regional DSD team acts as the first point of contact. The underlying pathophysiology of DSD and the strengths and weaknesses of the tests that can be per...

According to the seventh edition of diabetes atlas, 415 million persons all over the world are diabetics requiring more than 680 billion US $ annually for their management. Diabetes affects middle and low socio economic countries than developed countries. The ADA/EASD guidelines included drug price as one of the criteria to choose from different classes. Incretin based therapy are new classes for treatment of T2 DM with low incidence of hypoglycemia and modest weight loss, but...

Fragility fractures in the young individual are an uncommon clinical scenario and when faced with such a situation, appropriate assessment is required to ensure correct diagnosis of the underlying aetiology and to avoid unnecessary interventions. Although, primary causes of osteoporosis such as osteogenesis imperfecta are considered rare, this group of conditions has considerable phenotypic and genotypic heterogeneity and may be underdiagnosed. However, the majority of the you...

Introduction: Here, I present an interesting case of stuttering priapism in a 48 years old man. He was 30 years old when he was diagnosed with this condition. He is being treated with cyproterone acetate with significant improvement in his symptoms.Clinical case: A 30 years old man (now 48) presented to A&E with painful prolonged erection (priapism). He denied any history of trauma, blood disorders, use of recreational drugs, over the counter drugs o...

Introduction: I present here a challenging case of gastrinoma which posed challenges in diagnosis and treatment. Gastrinomas are tumours of pancreas or duodenum secreting excessive gastrin leading to acid over secretion in stomach leading to ulcer, perforations, and diarrhoea.Clinical case: A 77-year-old lady had been suffering from gradually worsening bouts of severe watery diarrhoea and vomiting for previous 10 years and six stones weight loss. Frequen...

Background: I present a young girl with maturity onset diabetes of young type 5 (MODY 5) who presented with renal cysts and early onset bilateral cataracts with gradual decline of beta cell functions.Case: 19 years old girl presented to A&E with hyperglycemia, ketosis, and acidosis. This was her second presentation in A&E in previous 3 weeks. She was diagnosed with type 1 diabetes when she was 3 years old in view of her polyuria and slow growth. ...

Introduction: I present here a patient with congenital adrenal hyperplasia and Fragile X syndrome. The two conditions are rare and not known to be related to each other.Clinical case: A 26-years-old lady was referred to Endocirne clinic with primary amenorrhoea. She complained of hirsutism and some facial acne since 14 years of age. To the best of her recollection her thelarche was around 12 years of age and pubic hair started to appear at 10 years of ag...

Introduction: Prolactinoma and macroprolactin are important differentials in the diagnosis of hyperprolactinaemia. We present the case history of a patient with hyperprolactinaemia due to an unusual coincidence of macroprolactin and a non-enhancing pituitary lesion. Case history: A previously well female police officer aged 29, was referred to the endocrine clinic with a history of amenorrhoea and mastalgia for 3 years. She also complained of nausea, dizziness, weight gain, th...