Endocrine Abstracts

A 60-year-old woman presented to the endocrine clinic with significant hirsutism and male-pattern baldness, progressive since the menopause 5 years earlier. She was otherwise fit and well. Testing revealed an elevated serum testosterone of 14.2 nmol/L. A CT scan revealed a large malignant 19 cm mass arising from the left adnexa, a large fibroid uterus and 2 small masses in the left kidney. Other abdominal organs were normal with no visible ascites. With the presumption of mali...

Introduction: Nearly all patients with type 1 diabetes mellitus develop diabetic retinopathy (DR) within 20 years of diagnosis. It is the second largest cause of blindness in those of working age in the UK. Several risk factors have been accepted by the Royal College of Ophthalmologists, including gender, duration of diabetes, glycaemic control, blood lipid profile, blood pressure, and renal impairment.Aim: To study the epidemiology of DR and its associa...

A 26yr old man presented to haematology with a short history of easy bruising. There was no spontaneous bleeding. Past medical history was unremarkable. Family history of clotting disorders was negative. On examination there was significant lower limb bruising.Initial investigations revealed platelets of 238 (150–450), prothrombin time (PT) of 12.0 (12.0–17.0 s) and elevated activated partial thromboplastin time (APTT) of 41.0 (24.0–38.0 s...

Testosterone in serum may be unbound (free), or bound to either sex hormone binding globulin (SHBG) or albumin. Consequently, ‘total’ serum testosterone analysis may be misleading in situations where binding protein concentrations are abnormal. Current methods for estimating the biologically active (bio-available) serum testosterone concentration involve physical separation of testosterone fractions and are not amenable to high-throughput analysis. The use of automat...

Hypopituitarism usually is the result of a pituitary tumour or its treatment. If, however, pituitary imaging is negative then an alternative diagnosis should be sought. We present two patients initially diagnosed as idiopathic hypopituitarism in whom the underlying diagnosis was delayed with potentially serious consequences.The first case was of a 32 year old male who presented with symptoms and signs of hypogonadism. Serum testosterone (<0.7 nmol/L)...

Folliculostellate (FS) cells form a three-dimensional network within the anterior pituitary gland and play a key role in regulating the endocrine response to inflammation and anoxic stress. Adenosine, released under such conditions in high concentration, modulates a number of inflammatory processes and can regulate the activity of the hypothalamic-pituitary-adrenal (HPA) axis. The identities of the adenosine receptor (AR) subtypes mediating these responses, however, and the si...

Introduction: Although significant developments have been achieved in the management of steroid-dependent patients, little progress has been made in ensuring their safety using smartphone technology. We present the use of a novel app in steroid-dependent patients.Methods: A group of unselected individuals currently on steroid replacement due to adrenal insufficiency (AI) were assessed regarding their access to intramuscular (IM) hydrocortisone. A smartph...

Introduction: Ectopic Cushing’s syndrome constitutes the second most common paraneoplastic syndrome and has been seen in 1-5 % of small cell lung cancers. It has a poor prognosis and can present with life-threatening complications.Case: We present a 66-year-old lady who attended with peripheral oedema, bruising and visual blurring. Past medical history included bronchiectasis, oesophageal web, ischemic colitis, Ehlers Danlos syndrome, and hypoxic br...

Carbimazole is one of the most commonly prescribed endocrine medications. There are a wide range of side effects associated including bone marrow disorders, severe cutaneous reactions, agranulocytosis and vasculitis. There have been few reports of anti-thyroid associated arthritis, described as migratory arthritis with prompt resolution following medication discontinuation. Side effects reported in British national Formulary and Electronic Medicine Compendium include myopathy ...

Background: In December 2017, a Nurse-Led AI clinic was introduced at University Hospital of Wales, Cardiff for the evaluation and follow-up of these patients. The clinic pathway was based upon the 2016 European Society for Endocrinology (ESE) guidelines on the management of adrenal incidentalomas.Aim: To evaluate the effectiveness of this new service and the cost-saving benefit.Methods: Electronic and paper-based patient records w...