Endocrine Abstracts

Assay interference with various laboratory measurements has been reported in the presence of paraproteins. We report a case of a 57 year old woman, who was referred to endocrine clinic after being found to have elevated total vitamin D levels of 369 and 336 nmol/l (normal 50–100 nmol/l). She was not known to be on any Vitamin D supplements that could account for such high levels. Around the time of referral, she was also diagnosed with IgM paraproteinaemia. Therefore, pos...

A 41 year-old male was referred urgently from secondary care with high suspicion of Cushing’s syndrome. His past medical history included psychosis and bipolar disorder, previous low impact foot fractures, rib fractures on coughing and spinal wedge fractures on X-ray, all within the last 5 years. He was taking quetiapine 300 mg modified-release and amitriptyline 10 mg daily, and tramadol 50 mg as needed. The patient reported decreasing mobility with increasing back pain, ...

Female with primary hypogonadism have inadequate function of the ovaries, with impaired production of germ cells (eggs) and sex hormones (oestrogen and progesterone). We recently came across a 22-year old female with short stature in childhood and adulthood she received growth hormone treatment (due to arrested puberty) between 3-5 years of age and further treatment at age of 10 years. She had history of IUGR, primary amenorrhoea, sensorineural deafness, congenitally missing t...

A 59-year-old woman with 46XY complete androgen insensitivity syndrome was referred back to our service. She also has history of hypertension and migraines. She was gonadectomised at the age of 15 years and treated with Ethinylestradiol. She married and was able to have enjoyable sex without the need for vaginoplasty or dilators. However, at 54 years she was firmly advised to stop Ethinylestradiol due to satisfactory bone density and “risks of HRT outweighing benefits&#14...

Case history: We report an interesting case of a rare cause of hypopituitarism where our patient presented to the hospital with acute onset headache, vomiting, and feeling generally unwell. Investigations/Results: On routine bloods, he was found to have hyponatremia. On further workup of hyponatremia, he had low morning cortisol which was confirmed as secondary adrenal insufficiency on dynamic function testing. He was also deficient in gonadotrophins alo...

Introduction: Historically there are many examples of doctors using language which does not aid joint decision making with patients. At medical school we are taught to find out the presenting complaint rather than the reason for attendance. We write about non-compliance with treatment in the medical records rather than barriers to adherence. Similarly we use language in the Diabetes clinic which can disempower the children and families who attend our clinics.<p class="abst...

Sarcoidosis is a multiorgan disease often affecting the lungs and lymphatic system. Neurological involvement occurs in sarcoidosis as granulomas infiltrate the nervous system. Here, we present a case of neurosarcoidosis diagnosed following non-specific neurological symptoms and delayed hypercalcaemia. A 32-year-old female presents with headaches, vomiting and acute confusion. During admission she developed unresponsive episodes. She has a background of type 1 diabetes and hypo...

Introduction: Definitive treatment of hyperthyroidism with Radioactive Iodine (RAI) ablation therapy has been associated with weight gain from RAI induced hypothyroidism. Literature on weight data of post-RAI patients following normalisation of thyroid function is equivocal.Objective: We undertook a retrospective study to evaluate the effect of RAI on weight in Hyperthyroid patients in University Hospitals of Leicester NHS Trust (UHL). <p class="abst...

Adrenal haemorrhage is a serious condition that can result in adrenal insufficiency, shock, acute adrenal crisis, and mortality if not managed with adequate treatment. Hereby we present two cases of non-traumatic bilateral adrenal haemorrhage highlighting their management during the acute phase.Case 1: 57 year old female presented due to chest pain, palpitations and troponin rise with a background history of antiphospholipid syndrome on anticoagulation. ...

Introduction: Brown tumors or osteitis fibrosa cystica are benign bone tumors complicating uncontrolled primary or secondary hyperparathyroidism. They may behave aggressively and can be destructive. Their osteolytic aspect may be misinterpreted as skeletal metastases.Methods: A 37-year-old female patient with chronic renal failure on dialysis, presented with pain and swelling of her left knee for 10 days, with no associated trauma. She gave history of tu...