Endocrine Abstracts

A 30 year old gentleman was admitted to our department with symptoms of tiredness and weight loss over the past 3 weeks. He also gave a history of erectile dysfunction for several years. His only significant past history was asthma well controlled on inhalers. On examination he appeared tanned. There was no buccal or skin crease pigmentation. Smell sensation was normal and he had normal external genitalia and secondary sexual characteristics.Initial inve...

Introduction: Myxoedmea coma is an extreme expression of hypothyroidism with a high mortality rate. It is rarely associated with thyroid lymphoma.Case report: A 66-year-old lady presented acutely unwell with a two week history of cough and shortness of breath. She was hypothermic, hypoxic with clinical and radiological signs of pneumonia. Her TSH was 99.8 mU/L and T4 less than 5 pmol/L with strongly positive thyroid microsomal antibodies, raised WBC and ...

A 14 year old girl, with a family history of MEN1, presented with secondary amenorrhoea and weight gain. Biochemical investigation revealed raised 24-hour urinary free cortisol excretions (1455, 1190, 614 nmol/24 hours; normal <290) and failure of cortisol suppression following 48 hours of low dose (0.5 mg qds) dexamethasone (199 nmol/l to 202 nmol/l). High dose dexamethasone administration (2 mg qds) for 48 hours resulted in further suppression of serum cortisol to 49 nmo...

Background: Before synthetic cortisone was introduced, patients with Addison’s disease prolonged their lives by maintaining a high salt intake and taking plant based containing preparations affecting steroid metabolism. We report the case of someone who discovered this regime for herself.Case report: A 42 year old lady presented with a four week history of decreased energy, malaise, and postural dizziness. She was hyponatraemic (plasma sodium 126 mm...

IntroductionThe thresholds of late night salivary cortisol (LNSC) vary widely among studies due to differences in assay methodologies and in control groups. We aimed to verify the analytical performance of the LNSC by electrochimiluminescence assay (ECLIA) and to establish cut-off values of LNSC for the screening of Cushing’s syndrome (CS).MethodsPatients with suspected CS underwent screening tests inclu...

IntroductionEctopic thyroid gland (ETG) is a rare developmental disorder, and when occurs in the midline of the neck, it mimics the clinical presentation of thyroglossal duct cyst (TGDC). inadvertent surgical removal of ETG simulating TGDC has been reported in the literature in spite of the modern diagnostic methods for this pathology.1, 2. We report a case of a 27-year-old female with Hashimoto’s thyroiditis of ectopic thyroid in whom a ...

Introduction: Primary hyperaldosteronism is the first cause of secondary hypertension during pregnancy. The diagnosis is too difficult due to the changes in the renin angiotensin system.Observation: We report the case of a 37 years old women with a history of pre-eclampsia during her pregnancy who consulted the emergency 20 days after delivery for severe hypertension (23/11) and severe hypokalemia (2.2 mmol/l ) resistant to intravenous treatment. The ald...

Introduction: Thyroid storm is an acute exacerbation of hyperthyroidism, responsible for significant mortality despite treatment.Case report: We report the observation of a 43-year-old diabetic patient with basedow’s disease with poor therapeutic adherence; admitted for convulsions and loss of consciousness. The diagnosis of acute thyroid storm on drop out of treatment was mentioned, in front of the detection of peripheral hyperthyroidism with low ...

We present the case of a 51 years old woman, nonsmoker, without relevant past medical history, who presented with acute psychotic state starting the third day of treatment with prednisone 30 mg indicated for allergy. She had also arterial hypertension and a significant and progressive loss of proximal muscle strength in her legs. The initial evaluation showed hyperglycemia, metabolic alkalosis and severe hypokalemia. Basal plasma cortisol was high (>90 μg/dl) and did ...

We present a 38-year-old patient who had adrenal insufficiency following laparoscopic removal of 3.2 cm cortisol-secreting right adrenal tumour. His biopsy showed adrenocortical adenoma in keeping with Cushing’s syndrome. He had a history of hypertension with suboptimal control despite being on 3 anti-hypertensives. His early morning cortisol (by GP to investigate secondary causes) were elevated and this prompted Endocrine referral. Clinical history and examination were ...