Endocrine Abstracts

Case history: Our patient is a 64 year old lady who had bilateral adrenalectomy in 1978 for Cushing”s disease. This was followed by radiotherapy in late 1978. To get further reduction of the ACTH producing pituitary adenoma she had transsphenoidal surgery in 1979 and then transfrontal craniotomy in 1982. This was followed by further radiotherapy in 1985. It left her with panhypopituitarism and she was on full hormone replacement. She presented to our hospital in late 2008...

25-years-old lady presented to gastroenterologist with recurrent bouts of vomiting associated with abdominal pains, fatigue, muscle aches and dark tan. Initial biochemical profile and upper GI endoscopy were normal. On examination she had dark pigmentation of the palms well hydrated and haemodynamically stable. No family history of autoimmune conditions. She had traumatic laceration of the liver as a child, otherwise no significant past medical history.A...

Introduction: Hypopituitarism due to Sheehan′s syndrome is a rare complication and its diagnosis is often overlooked. The vast majority of people with hypothyroidism have primary hypothyroidism, often due to Hashimoto’s thyroiditis. Coexistence of hypopituitarism and primary hypothyroidism, may accelerate clinical manifestations, mainly those associated with hypothyroidism. Hashimoto′s Thyroiditis with concomitant hypopituitarism is rare but has been described...

History: A 52-year-old woman was referred by her GP for colonoscopy in view of 7 months” history of unexplained weight loss of nearly 2.5 stones, constipation and recently detected normocytic anaemia. Her past medical history was unremarkable except for bronchial asthma that was managed with albuterol. However, on the day of the scheduled colonoscopy, she was noted to be hypotensive (BP- 63/38 mm Hg, heart rate 93 bpm) and was hence admitted for fluid resuscitation. Follo...

Background: Early diagnosis of Cushing’s syndrome and initiation of effective treatment are essential to limit long-term morbidity and early mortality. However, diagnosis is often delayed due to the non-specificity of symptoms, or because symptoms are not recognised by physicians, leading to more complex treatment needs and a worsening of patient quality of life. A survey was conducted to better understand the patient experience of Cushing’s syndrome and the true b...

Cushing’s disease is relatively rare and affects most commonly adults aged 20 to 40. It is associated with high morbidity and mortality; early detection and diagnosis of Cushing’s disease may lead to decreased this two facts and improved quality of life.We present a 32-year-old man with abdominal purple striae, central obesity with typical ‘moon face’ and oscillatory blood pressure values.Hormonal exams revealed...

IntroductionThe main role of vitamin D is regulating bone metabolism, but over the past years, the importance of vitamin D in non-skeletal actions has been studied. Vitamin D deficiency is very common in our environment. This deficit has been associated with higher risk of many chronic diseases, such as osteoporosis, hypertension, diabetes and even obesity. Recent evidence has demonstrated an association between low vitamin D status and autoimmune thyroi...

Glucocorticoids have potent effects on almost every tissue in the body and this is exemplified in patients with Cushing’s disease. Whilst Cushing’s disease is rare, glucocorticoids are commonly prescribed for their anti-inflammatory actions, but their use is associated with a series of undesirable adverse effects, including obesity, insulin resistance, hypertension, myopathy and osteoporosis. Within tissues, glucocorticoids (both endogenous and exogenous) are metabol...

Adrenal crisis is a life-threatening emergency requiring immediate treatment with high glucocorticoid doses. In diagnosed Addison’s disease between 3.8% and 29% of patients are estimated to need emergency hospital treatment per annum (Arlt & Allolio, 2003; Fleming & Ostergaard Kristensen, 1999).In 2003 we conducted the largest international survey of diagnosed Addison’s patients to date (N=868), enquiring about the causes and fre...

A number of psychiatric conditions are associated with Cushing’s disease. Acute psychosis is rare. We describe a patient with sudden onset of florid psychosis who required medical and surgical treatment.Case: A 38 year old woman previously well and employed in the financial sector was admitted to the acute psychiatric unit with delusional, disorganised and paranoid ideation. Despite management with olanzapine, haloperidol and benzodiazepines her men...