Endocrine Abstracts

45/M presented to hospital with h/o assault on head (hit by meat cleaver). Background history of drug abuse and previous drug induced psychosis. Trauma CT head revealed mass in the enlarged pituitary fossa. MRI head revealed 5 x 4 cm mass in the sella turcica encasing the internal carotid vessels but sparing optic chiasma. Visual field examination was normal and no other clinical symptoms were present. Serum prolactin was 67922. Tumor was not for resection so medical treatment...

Section 1: Case history: Persistent hyperinsulinemic hypoglycaemia may be caused by either a solitary tumour of the pancreas secreting excessive insulin, i.e. an insulinoma or, rarely by nesidioblastosis. A 70-year-old man was referred with symptoms of hypoglycemia. He had a positive 72-hour-fast with episodes of hypoglycemia and high insulin levels. Section 2: Investigations: EUS showed a small 3 x 4mm hyperechoic lesion in the body of the pancreas. His...

Section 1: Case history: Adrenal haemorrhage in pregnancy is rare but life threatening. We present the case of a 23-year-old woman who developed idiopathic spontaneous bilateral adrenal haemorrhages during pregnancy. The patient, without significant past medical history, presented at 35 weeks of gestation with right sided lower thoracic and abdominal pain which was thought to be musculoskeletal in nature; she was discharged home once the pain settled. She represented at 37 wee...

63 year old gentleman, admitted in Nov 2018. Feeling generally unwell, decreased appetite, lethargy and poor mobility. Known lung cancer (diagnosed January 2018) On Immunotherapy last received in October 2018CT scan (September 2018) after 4 cycles of Pembrolizumab–excellent response to treatment. Routine blood tests were normal apart from a raised CRP at 551 and white cell count. A random cortisol level was done and found to be low at 135. Blood, urine, sputum and stool c...

Background: Approximately 20% of bariatric surgery candidates are excluded for reasons of mental health. All bariatric patients undergo a pre-operative assessment of suitability, including a mental health assessment. There are no NICE guidelines as to what level of mental illness is considered an exclusion; it is generally regarded that ‘unstable mental health’ is a contraindication to surgery. The main reason is concern regarding adherence to essential lifestyle cha...

Introduction: In this audit we explored the treatment and follow up of pre-2016 cases against the 2016 European Society of Endocrinology (ESE) guidelines on PPGL follow-up.Results: Demographics of the patients revealed 50% were male with median age (45±5), 82% of patients underwent surgery of which 73% were diagnosed with adrenal phaeochromocytomas & 27% with paragangliomas. Only 64% of surgical cases were followed up in clinic in the last year....

A 55 year old man was seen in an endocrinology clinic for possible diagnosis of Cushing’s syndrome. He described a 6 months history of feeling lethargic and increased facial puffiness and abdominal fat. There Cushingoid signs on examination, namely; moon facies, thin skin and bruises with increased abdominal fat distribution. He was admitted to hospital following symptomatic hyperglycaemia and hypokalaemia (lowest reading 2.7 mmol/l). Initial laboratory results showed rai...

A 74-year-old with a history of type 2 diabetes, chronic kidney disease, vitamin D deficiency and bronchiectasis was referred to the medical team with symptomatic hypercalcaemia with raised adjusted calcium of 3.80 mmol/l. Investigations also showed raised creatinine and vitamin D levels; normal parathyroid hormone (PTH) and angiotensin-converting enzyme (ACE). Myeloma screen was negative. A diagnosis of primary hyperparathyroidism was made in view of elevated calcium and norm...

Background: As radioiodine therapy is highly effective in curing Graves’ hyperthyroidism and toxic multinodular goitre, the assessment of its efficacy by rendering those patients euthyroid while avoiding the development of permanent hypothyroidism, is important.Aim: To determine the current practice of radioiodine treatment provided at our trust, in line with the recommended guidelines of the Royal College of Physicians and also to compare our succe...

A 50 year old man was admitted in September 2017 with left sided thoracic pain. A chest radiograph revealed a left-sided hilar mass. CT of thorax demonstrated a large, left-sided, anterior mediastinal mass with associated lymphadenopathy and sclerotic bone metastases. A CT-guided biopsy was performed and pathology was consistent with carcinoid tumour. The patient was referred to clinical oncology. An NM octreotide scan confirmed a left-sided avid lesion within the thorax. Gut ...