Endocrine Abstracts

A 68 year old retired accountant presented with loss of libido, reduced shaving frequency, obesity and gynaecomastia. His past medical history included osteoarthritis and facial acne. There was no related family history and he was taking no medications. He reported having two children.On examination the BMI was 31.7 kg/m2 and height 181 cm. He was normotensive and bilateral gynaecomastia was noted. He has reduced body hair; testicular volume w...

37 year old gentleman presented with Cushing’s disease at the age of 15 with obesity, growth retardation, and vertebral fracture. After bilateral adrenalectomy and pituitary irradiation he was treated with hydrocortisone and fludrocortisone. After being lost to follow up for a number of years he was referred to our endocrine clinic in 1999. Clinical examination revealed that he was obese (BMI 39.2), hypertensive and had marked abdominal striae. Investigations revealed an ...

A 30 year-old man was assessed for gynaecomastia. He had been treated for GH deficiency from the age of 3 to 16. His non-consanguineous parents were of short stature (maternal height 1.22 m, paternal height 1.58 m), as was a half-sister (1.55 m). The patient’s height was 1.55 m with an arm span of 1.48 m and his BMI was 31. Testicular volume was 18 mL and secondary sexual characteristics were normally developed. Lipomastia was diagnosed and subsequently treated surgically...

A 23 year-old male was assessed for recommencement of growth hormone replacement therapy. He had discontinued treatment a year ago but not experienced any adverse symptoms since.The patient had been born with multiple congenital malformations. Midline defects included oesophageal atresia, imperforate anus and partial sacral agenesis. Urogenital abnormalities required a left nephro-ureterectomy soon after birth and an orchidopexy was performed at the age ...

A 64 year-old Eritrean female presented with a toxic multinodular goitre. Free T4 was 37.8 pmol/L, TSH <0.01 mU/L, and a neck ultrasound scan showed areas of calcification. A Technetium scan revealed an increased tracer uptake of 9.8% with a right-sided dominant nodule and photopenic areas. An ablative dose of radio-iodine was administered as she did not tolerate thionamide therapy.Six months later the patient reported intermittent hoarseness of voic...

In 1981 a 33yr old woman was diagnosed with Graves thyrotoxicosis and type 2 diabetes mellitus. At diagnosis her BMI was 19 kg/m2 and she was initially treated with carbimazole and glibenclamide. She had a past medical history of idiopathic lymphoedema, asthma and bronchopulmonary aspergillosis and was regularly reviewed by an ophthalmologist for hyperpigmented maculae.In 1991 she required insulin to control her diabetes and developed progress...

In 1981 a 33 yr old woman was diagnosed with Graves thyrotoxicosis and type 2 diabetes mellitus. At diagnosis her BMI was 19 kg/m2 and she was initially treated with carbimazole and glibenclamide. She had a past medical history of idiopathic lymphoedema, asthma and bronchopulmonary aspergillosis and was regularly reviewed by an ophthalmologist for hyperpigmented maculae.In 1991 she required insulin to control her diabetes and developed progres...

A 32 year old women presented to her G.P.with a four month history of a lump in her neck, weight loss and anxiety. She had hyperthyroidism (TSH <0.1 mU/l, fT4 >100 pmol/l, TPO antibodies 318IU/ml). Thyroid U/S showed a 2x3cm nodule in the right lower pole. A thyroid isotope scan was reported as showing increased uptake throughout the gland with an area of decreased uptake in the right lower pole. She was started on carbimazole 30mg o.d. and she was referred to a head and ne...

A 62 year old lady presented to the clinic with hirsutism, virilisation and temporal balding. Her past medical history included type 2 diabetes, hypothyroidism, ischaemic heart disease and peripheral vascular disease. Her body mass index was 30 kilograms per metre squared and she had mild cliteromegaly. Her serum testosterone was 3.6 nanomols per litre.She had a high dose dexamethasone suppression test and CRH test to exclude Cushings Syndrome or Disease...

Short stature in thalassemia major: multiple aetiologies.A 24 year old Asian male with beta-thalassemia major was referred with symptoms of tiredness, weight gain, muscle weakness and depression. He had been treated elsewhere with blood transfusions, desferrioxamine and had undergone a splenectomy. He was known to have underlying cardiac dysfunction and was diagnosed to have hypogonadotrophic hypogonadism at the age of 17 years and primary hypothyroidism...