Endocrine Abstracts

Introduction: Autoimmune polyendocrine syndrome type 2 is a rare disease characterized by the presence of autoimmune Addison’s disease in combination with thyroid autoimmune disease and/or type 1 diabetes mellitus, and possible occurrence of other autoimmune non-endocrine disorders. The combination of the three glands diseases is even rarer and is referred to as Carpenter’s syndrome.A long time interval is often present between the manifestatio...

Introduction: Diagnosis of sub acute thyroiditis is readily considered in a patient presenting with classical history and characteristic clinical features. Confirmation of diagnosis is based on particular set of laboratory investigations and supported by characteristic imaging findingsof Tc-99 scan. However, prescence of sub acute thyroiditis with normal thyroid scintigraphy findings is exceedingly rare.Case report: 51 years old postmenopausal female wit...

Pulmonary arterial hypertension (PAH) is a devastating disease characterised by increased pulmonary arterial pressures due to clustered proliferation of cells within the vessel. Untreated this leads to right heart failure and premature death. PAH predominates in females implicating sex hormones, in particular estrogenic metabolites, as being key in the progression of PAH phenotypes. We hypothesised that hydroxy and methoxy estrogens, with known proliferative and anti-prolifera...

Background: Empagliflozin is a sodium-glucose-cotransporter-2 that improves cardiovascular risk and weight loss in patients with type 2 diabetes. Polycystic ovary syndrome (PCOS) is associated with obesity and increased cardiovascular risk; therefore, empagliflozin may be of benefit in PCOS.Methods: A randomised, open-label study in 40 overweight and obese women with PCOS treated with either empagliflozin 25 mg or metformin 1500mg daily for 12 weeks....

Milk Alkali syndrome (MAS), a rare cause of hypercalcaemia, is reversible and caused by the ingestion of large amounts of calcium (Ca) and absorbable alkali. We report a case of MAS in a 37 year old female, admitted with Ca of 3.44 (2.15–2.62 nmol/l). Presenting complaints include 6 months history of worsening fatigue, thirst, polyuria, abdominal pain and a complex background of bipolar disorder, fibromyalgia, spina bifida, lumbar spine fusion and extremely limited mobili...

A 48 years old lady with BMI of 46kg/m2 was postmenopausal since age 45. Due to abdominal discomfort she had an abdominal CT, which incidentally identified bilateral adrenal adenoma (9 mm on right, 18 mm on left, with fat content). This resulted in Endocrinology referral and a history of gradually worsening hirsuitism was uncovered. Her hyperandrogenism was confirmed biochemically with markedly elevated testosterone at 6.5 nmol/l (0.0–1.8), leading to a search ...

Vascular disease is a major cause of morbidity and mortality in people who have diabetes. Hyperglycaemia is associated with increased transcriptional activity of nuclear factor of activated T cells (NFAT) in the vasculature. NFAT activation enhances expression of pro-inflammatory mediators including osteopontin, COX2 and IL6, implicated in the development of vascular disease. This study investigated the therapeutic potential of NFAT inhibition on the progression of microvascul...

Background: Circulating levels of total oestradiol (E2) decrease with age in adult males; the effect of altered E2 circadian rhythm is uncertain. We hypothesised that age-related changes in the circadian rhythm contribute to decreased BMD in older males and investigated this.Methods: Nineteen subjects were studied: six young-healthy (YH) males (mean age (years) 27.3±4.6) with normal BMD, eight older-healthy (OH) males (mean age...

A 31-year-old woman presented with oligomenorrhoea and a raised prolactin. Pituitary scan revealed a 1.8 cm pituitary mass with compression of the optic chiasm. TSH was normal at 3.66 mIU/l with a raised FT4 of 25.8 pmol/l. The rest of pituitary function was normal. Visual fields demonstrated a bitemporal upper quadrantanopia. A diagnosis of TSH-secreting pituitary adenoma was suspected because of the high normal TSH in the presence of a high FT4. She und...

: A 61-year-old gentleman was referred to the Endocrine team with acute bilateral adrenal haemorrhage. He had undergone a successful left popliteal embolectomy for critical limb ischaemia a week ago following which he was commenced on anticoagulation therapy. He presented to the Emergency Department with acute severe abdominal pain and low grade pyrexia of 37.6 C. He was haemodynamically stable. His International Normalised Ratio was noted to be elevated at 4.7. An urgent abdo...