Endocrine Abstracts

19-year-old gentleman was initially investigated by his local hospital when he presented with 2-year history of diarrhoea, intermittent abdominal pain, sweating, and depression with suicidal ideation. His only past medical history was eczema. His maternal grandmother had PTHP aged 50 years. A paternal grandmother had colon and pancreatic cancer and cousin had Graves’ disease.Gastroenterology investigations were normal. However he was found to have h...

A 36-year-old lady (gravida 2 para 0) presented with subfertility, dysmenorrhoea and mild hyperprolactinaemia (prolactin of 881 mU/l no macroprolactin). She was also found to be hypercalcaemic whilst on calcium supplements. Despite a negative home pregnancy test, her β-HCG was elevated at 1471 IU/l confirming she was pregnant.She remained hypercalcaemic despite stopping calcium supplements and starting colecalciferol. At 9 weeks into her pregnancy, ...

A 64-year-old gentleman was referred with persistent hypercalcaemia following two previous parathyroidectomies from an external hospital. He was found to be hypercalcaemic incidentally by his GP in 2011. Prior to surgery in January 2011, his corrected calcium (cCa) was 2.83 mmol/l, PTH 1.9 pmol/l, vitamin D 38 nmol/l, 24 h urine calcium creatinine clearance ratio (24 h UCCR) was 0.0135. Histology from his 1st neck exploration revealed one hyperplastic parathyroid gland. A furt...

A 61-year-old lady presented with rapid onset of lethargy and reduced mobility with inability to use stairs over 1 month. Prior to this, she was fit and well and was a lifelong non-smoker. At presentation, she was overweight and had evidence of skin bruising and severe proximal myopathy of her legs. A midnight cortisol was >1710 nmol/l with a corresponding ACTH of 610 nmol/l confirming ACTH dependent Cushing’s syndrome. Serum potassium was 2.6 mmol/l and a new diagnos...

We present a case of 50-year-old female who presented to a local hospital with sudden onset severe sharp left flank pain. Urgent CT revealed a mass in the left adrenal gland which was thought to be a supra-renal bleed. It measured 6 cm at this point. She was discharged with paracetamol and re-assured. As she was not feeling well, she had an US kidney in private sector 1 month later revealing static appearance of presumed haematoma. Following the period of observation to allow ...

We present a family of a 45-year-old patient who presented to hospital acutely unwell with metastatic paragangliomas. Unfortunately due to rapidity of his presentation, no genetic testing was performed. He was found to have 5 cm right carotid body tumour. His urine collections confirmed raised (seven times normal) 24 h urine metanephrines 24.55 μmol (normal <3.47 μmol). Shortly after the initial diagnosis he was found to have extensive vertebral body metastases i...

A 43-year-old gentleman was referred from a local hospital with biochemical and radiological suspicion of pheochromocytoma. He admitted to a 10-year history of palpitations, flushing, sweating, and tremors. He was intermittently feeling stressed, anxious and angry with mood swings. He had difficulty sleeping and suffered from headaches. He was treated for hypertension and 10 years prior he was admitted to the local hospital with malignant hypertension. He was drinking up to 40...

A 68-year-old patient was noted to have prognathism, broad fingers and toes and coarse facial features during her admission for a hip replacement 2 years ago. Her family noted change to her facial features and she admitted to increase in her shoe size over 10 years. Her past medical history included treated hypertension only. Her oral glucose tolerance test (OGTT) confirmed paradoxical rise of GH with peak 6.23 μg/l. Her initial IGF1 was raised at 131 nmol/l (6–30 nm...

A 33-year-old woman was referred to our service for investigation of secondary amenorrhea. She is from India and moved to the UK 8 years ago. She has two children aged 7 and 4 years. She has a history of TB adenitis treated in 2007 with quadruple anti TB medication for 6 months. She was told she had no pulmonary involvement and was clear after treatment. She is currently on no medication. During 2012 she noticed her menstrual cycles were lengthening with amenorrhoea since Janu...

A 53-year-old retired military soldier had a 9 months history of recurrent blackouts predominately associated with blurred vision, feeling shaky, sweaty and they were mainly before meal. His past medical history included asthma, multiple shrapnel injuries, hearing impairment secondary to blast injury. He was on atorvastatin, ompeprazole and inhalers.He was admitted acutely to his local hospital and blood glucose 0.6 mmol/l was found. Prolonged 72 h fast ...