Endocrine Abstracts

A male with classical salt-wasting congenital adrenal hyperplasia (CAH; 21-hydroxylase deficiency) who was diagnosed in infancy and had normal pubertal growth and development attended the endocrine department for routine follow up in June 2019 (age 26). His current daily medications are hydrocortisone 10 mg on waking, 5 mg at 4 pm and fludrocortisone 200 mg once daily. He also has injectable hydrocortisone sodium phosphate 100mg for emergency use. Over recent years, he reports...

A 17 year-old female was referred to Endocrinology with primary amenorrhoea and arrested puberty (B4 PH4 AH2). She reported breast development in line with her peer group and had experienced a single “show” of vaginal spotting aged 15 years. Although guidelines recommend baseline pelvic USS in the investigation of primary amenorrhoea, it generally only adds value in females with high LH+FSH and abnormal karyotype; indeed, it may raise undue concerns of uterine (Mulle...

Case history: A 26-year-old female presented with acute left-sided loin pain. There was a preceding dull ache for two months. She had no dysuria or haematuria. Her past medical history was unremarkable except for rhinosinusitis. Investigations: Abdominal CT revealed oval shaped lesion adjacent to the upper pole of the left kidney. The left adrenal gland could not be separately visualized. The lesion had mass effect on the fundus of the stomach. Adrenal M...

Case History: A 68-year-old gentleman was admitted to the hospital following a history of weight loss, lethargy, tiredness for about 6 months. His past history includes hiatus hernia, esophagitis and kidney stones. He reported taking over the counter vitamin D (60,000 IU daily) for more than 2 years. He was not on any other regular medications.Investigations: His initial investigations showed acute kidney injury with severe PTH independent hypercalcaemia...

Background: Success of Graves’ orbitopathy (GO) immunosuppression treatment is highly variable; patients relapse and a debilitating residual disease burden often remains with current therapies. This study describes the outcomes of immunosuppression in a multi-ethnic GO cohort treated in accordance with pre-2021 European Group on GO (EUGOGO) guidelines with first-line intravenous-methylprednisolone (IVMP). This study aims: (1) To evaluate the effect of first-line and addit...

Introduction: Adrenal incidentalomas (AIs) are increasingly being identified due to more frequent use of cross-sectional imaging modalities. Recent studies reported AIs being identified in 7.3% of abdominal CT imaging. Most adrenal incidentalomas are adenomas that may have secretory activity.Case Report: An 80-year-old lady presented to our Emergency department with one week’s history of worsening right eye bulging and discomfort. She was found to h...

Background and Aims: The objective of our study is to evaluate the degenerative profile in diabetic patients and their glycemic controlMaterials and Methods: This analytical cross-sectional study for analytical purposes was conducted during the period from January 2022 to January 2023, within the department of endocrinology and metabolic diseases of the Military Hospital of Instruction Mohamed V of Rabat.Results: 215 patients were ...

Background: Diagnostic work-up for Cushing Syndrome (CS) can be challenging and is based on clinical and biochemical assessments. Biochemical evidence of endogenous steroid excess is demonstrated through overnight dexamethasone suppression test (ODST), low dose dexamethasone suppression test and/or 24-hour urinary free cortisol estimation (UFC). Once endogenous steroid excess is confirmed, random serum ACTH measurement is key in determining the suspected source of steroid exce...

We present two cases of alternative approaches to treating endocrine disease. Case 1: A 55-year-old man became steroid dependent in 2017, following a skiing accident and C3/4 fracture, for which he received 13-months of high-dose hydrocortisone. Upon cessation, he developed adrenal crisis, confirmed on short synacthen test. Hydrocortisone replacement therapy was begun. His dose was doubled, then tripled to control his symptoms, in addition to frequent re...

Section 1: Case history: A 69-year-old female with a past history of treated hypertension and Graves’ disease presented to the emergency department with a two-day history of headaches, vomiting, confusion and difficulty swallowing following a recent holiday in Spain. She had clinical meningism and a diagnosis of meningitis was made.Section 2: Investigations: After an initial CT scan of her head was reported as unremarkable, a lumbar puncture was per...