Endocrine Abstracts

Lymphocytic hypophysitis is a rare inflammatory disease of the pituitary gland. The aetiology is unknown though probably of autoimmune origin.We report the case of a 40 year-old woman who presented 39/40 weeks pregnant with an inferior bitemporal homonymous quadrantinopia. She had primary hypothyroidsim and had had previous unsuccessful in-vitro fertilisation, though this conception was spontaneous. Magnetic resonance imaging (MRI) demonstrated a large p...

Pretibial myxoedema (thyroid-associated dermopathy), an extrathyroidal manifestation of Graves disease, is a localized thickening of the skin due to accumulation of acid mucopolysacharides (glycosaminoglycans). Almost invariably, pretibial myxoedema occurs in the presence of ophthalmopathy.We report the case of a 57-year-old man of North African origin, who presented with pretibial myxoedema as the first manifestation of Graves disease. He was admitted w...

Diabetic ketoacidosis [DKA] is known to be precipitated by number of clinical situations which lead to increased production of counter regulatory hormones Substance abuse has recently been highlighted as a risk factor in DKA. Cocaine has not received sufficient emphasis. We report a case of multiple admissions for DKA associated with cocaine use.A 23 year old male student was brought to emergency room for altered sensorium of ten hours duration. He was a...

With the right balance of daily medication, individuals with adrenal insufficiency can expect to have a normal life span and to lead busy and rewarding lives. Despite this, research finds that people with adrenal insufficiency often feel below par compared to healthy individuals.(1)(2) One recent study found that the rate of hospital admission for adrenal crisis is almost three times higher for women with autoimmune adrenalitis than it is for patients with secondary adrenal in...

A 34-year-old woman with seasonal allergic rhinitis was poorly controlled with fexofenadine. She began to use beclomethasone nasal inhaler, 42 ug of drug per nasal pump unit, 2 sprays in each nostril twice daily. There was no history of substance use or drug intake. Two months later she complained of easy fatiguability, and pain in her thighs and arms, on walking distances and climbing stairs which were easily tolerated earlier. There was no history of proximal muscle weakness...

Gynaecomastia in elderly males is relatively common and could be due to age-related endocrinological and metabolic disorders, drugs and other medical conditions. We report on the case of a 72 year old male smoker who presented with a 10 month history of painful unilateral gynaecomastia, lethargy and weight-loss. He had a past medical history of type 2 diabetes, atrial fibrillation, ischaemic heart disease, hypertension, stroke and monoclonal gammopathy. He was taking Clopidogr...

Diabetes arising in young adulthood has a wide differential diagnosis, including autoimmune and genetic causes as well as young onset type 2 diabetes (YT2D). Specific features may be associated with each of these groups, but they cannot be differentiated from YT2D by mode of presentation. Family history, clinical characteristics and laboratory investigations provide complementary strategies to help dissect different known aetiologies.We studied 268 UK Ca...

A previously fit 36 year old lady presented with 3 days of pleuritic chest pain and SOB. A CxR showed consolidation at the left heart border. Following antibiotics she made a good recovery. On examination an incidental right thyroid nodule was identified. She was clinically euthyroid. FT4,FT3 were normal and TSH suppressed. The CxR a month later did not change. A CT scan revealed a 5x4cm mass in the left lower lobe, abutting the descending aorta and left atrium. Bronchoscopy r...

We assessed whether the hypothalamic-pituitary-adrenal (HPA) axis is affected after withdrawal of oral steroids in patients who have been on steroids for at least ten years. Recent advances in treatment of patients with severe asthma with inhaled fluticasone propionate, and the use of steroid sparing drugs such as methotrexate has allowed the withdrawal of long term oral steroids in patients who otherwise had steroid dependant disease.We performed a 250 ...

Seventy six-year-old man was referred to our hospital for examination of hypertension and hypokalemia. His blood pressure was uncontrolled although he was taking amlodipine besilate, spironolacton and candesartan. In addition, he suffered from atrial fibrillation and chronic heart failure. His serum potassium was low (2.8 mmol/l) and bilateral adrenal glands were found swelling. Hence, we investigated him thoroughly on the suspicion for primary aldosteronism.<p class="abst...