Endocrine Abstracts

A 34-year old pregnant lady had induction of labour with prostaglandins and oxytocin infusion after her due date. She failed to progress in labour and became slightly disoriented. Urgent biochemistry revealed serum sodium of 124 mmol/l. She delivered a healthy baby by forceps but had post-partum haemorrhage of 1.5 l. Oxytocin infusion was continued along with Hartmann’s solution. She became drowsy and biochemistry revealed serum sodium of 118 mmol/l, low serum osmolality,...

Background: This is associated with important physiological and psychobiological changes for the girl, the family and society. Decreasing the age of puberty has made it difficult to adapt to early sexual activity. Therefore, the diagnosis and management of precocious puberty must be specially considered to ensure the health of future generations. The appearance of secondary sexual characteristics in girls under the age of 8 is considered as precocious puberty (_2.5SD lower tha...

Objective: Personal continuous glucose monitoring (pCGM) with interstitial fluid glucose sensing is rapidly becoming the standard of care for real-time, intensive insulin therapy of diabetes. We report our experience of glycemic control in patients in an academic setting using minimally invasive pCGM with continuous s.c. insulin infusion (CSII, or insulin pump) vs CSII alone.Methods: Over a two-year period, we reviewed all patients treated with insulin p...

Multiple endocrine neoplasia type 1 (MEN 1) is a rare autosomal dominant disease characterized by pancreatic, parathyroid, and anterior pituitary tumours. Hypercalcaemia due to parathyroid tumours is usually the first manifestation. Pancreatic islet tumours occur less frequently, among them gastrinomas and insulinomas are the most prevalent. Insulinomas can be difficult to diagnose. It was not uncommon for patients to have been misdiagnosed with psychiatric illnesses or seizur...

Aim: To describe 2 cases of immune-mediated hypophysitis due to the therapeutic use of Ipilimumab, a cytotoxic T-lymphocyte antigen-4 (CTLA4)-blocking antibody.Case 1: A 62 year-old male with history of metastatic melanoma was started on Ipilimumab. After finishing the 4th at 2 months he complained of weakness, fatigue, and fever, prescribed ciprofloxacin and prednisone 20 mg daily, and felt better. 2 days later he was hospitalized with weakness, BP 86/6...

Case history: A 73-year-old female with a background of hypertension presented to the acute physicians with a 4 month history of progressive headaches. The headaches did not have any ‘red flag’ features. A non-contrast CT scan revealed an intrasellar lesion. She was referred to endocrinology for further management. Her history did not suggest hypopituitarism, Cushing syndrome or acromegaly. There were no visual field defects and her eye movements were normal.<p c...

Hypercalcaemia is one of the common cases seen in Endocrine clinics. We report another challenging case of hypercalcaemia. A 43 old Asian man was referred by GP initially in 2011 with asymptomatic hypercalcaemia of 2.87 mmol/L. His past medical history included chronic plaque psoriasis with arthropathy, hypertension, stage 3 CKD, Fatty liver with mild fibrotic change secondary to methotrexate and learning difficulties. Hypercalcamia was thought to be contributed by Dovonex (Ca...

Dexamethasone is used to reduce cerebral oedema thus relieve symptoms of raised intracranial pressure. Long-term use causes suppression of the hypothalamic–pituitary–adrenal axis, which can lead to adrenal insufficiency. Undiagnosed, significant morbidity and mortality can occur from Addisonian crisis. The aim of this audit was to discover the relationship between adrenal insufficiency and long-term steroid use, in order to make recommendations for the use and withdr...

Introduction: Adrenocortical carcioma, is an aggressive cancer originating in the cortex of the adrenal gland. Adrenocortical carcinoma is a rare tumor, in United State <25 new cases of adrenocortical tumours (benign and malignant) are diagnosed annually (0.1–0.4 cases/million per year) and malignant adrenal tumours comprise ~1% of all carcinomas diagnosed prior to 20 years of age. Adrenocortical carcinoma has a bimodal distribution by age, with cases clustering in ch...

Introduction: A short-synacthen test (SST) is routinely used to diagnose hypoadrenalism, however, some authors suggest using morning serum cortisol as an initial screening test to rule out hypoadrenalism. We assessed the utility of a morning cortisol as a screening test when compared with the outcome of SST.Methods: We retrospectively analysed SSTs carried out in our endocrine outpatient clinic in the last 3 years (649 results). Of these, 113 were identi...