Endocrine Abstracts

Introduction: Pancreatitis due to hypercalcemia from primary hyperparathyroidism is rare with an incidence of 1–1.5%. We report on a case of recurrent pancreatitis secondary to an ectopic parathyroid adenoma with co-existing severe vitamin D deficiency with its management difficulties.Case report: A 45-year-old male admitted to the hospital with abdominal pain and attendant nausea had investigations ruling out structural lesions for his symptoms but...

A 55-year-old lady was admitted with sudden onset headache, diplopia, photophobia and confusion. CT brain showed SAH with hydrocephalus. Coiling of the aneurysm with EVD insertion was done on the same day. On day 5 post-operatively she developed hyponatremia and dropped her GCS to 10/15.On examination she was volume depleted with dry mucous membranes and loss of skin turgor. Urine output over the previous 4 days had been 2.5–4 l/day, urinary sodium ...

Pituitary apoplexy is uncommon and the incidence is quoted to be between 5 and 16% in pre-existing pituitary adenomas. Recurrent pituitary apoplexy is rarer; we report 2 such cases.A 22-year-old female underwent transsphenoidal resection of an expanding intrasellar lesion in 1987. She was commenced on hydrocortisone for cortisol deficiency and on subsequent follow-up, on thyroxine. She required repeated surgery in 2003 and 2005 after she presented with h...

Radio-iodine is a safe and effective treatment of thyrotoxicosis, but carries a risk of the late development of hypothyroidism several years after therapy. Patients treated with radio-iodine require long-term follow-up to ensure that late hypothyroidism is detected and treated. Current changes in health care commissioning propose an increasing reliance on primary care for the long term follow-up of patients with thyroid disease. We report a study of the 8 year follow-up of 100...

A 75-year old gentleman presented with symptoms of increasing lethargy, loss of appetite associated with weight loss and constant micturition. A CT scan showed extensive peritoneal mass in the lower abdomen and pelvis with disseminated intraperitoneal malignancy. A CT guided biopsy confirmed a poorly differentiated tumour. Immunohistochemistry showed that all the cytokeratin markers were negative, but vimentin was positive and CD117 (c-kit) was strongly positive, indicating th...

We report the case of a 74 year old woman, admitted as an emergency with suspected pelvic malignancy in whom the clinical features and the positive tumour markers were actually due to hypothyroidism. The presenting features included cachexia, anorexia and severe ascites. Vital signs were normal. Examination revealed bilateral pleural effusions but no abdominal masses were palpable. Rectal examination was unremarkable. Investigations showed an extremely elevated CA 125 level of...

A 79-year-old man presented with a fall and vomiting. The finding of significant postural hypotension associated with severe hypotonic hyponatraemia (Na 114 mmol/L, Osmolarity 244 mmol/L) mandated a Short Synacthen Test (cortisol 98 mmol/L at baseline and 238 mmol/L 30-minute post synacthen) and ACTH (6 ng/L) which confirmed central hypoadrenalism. This led to revelation of multiple pituitary axes involvement: hypogonadism (testosterone 1...

A 79-year-old man presented with a fall and vomiting. The finding of significant postural hypotension associated with severe hypotonic hyponatraemia (Na 114 mmol/L, Osmolarity 244 mmol/L) mandated a Short Synacthen Test (cortisol 98 mmol/L at baseline and 238 mmol/L 30-minute post synacthen) and ACTH (6 ng/L) which confirmed central hypoadrenalism. This led to revelation of multiple pituitary axes involvement: hypogonadism (testosterone 1...

Adrenal haemorrhage is a serious condition that can result in adrenal insufficiency, shock, acute adrenal crisis, and mortality if not managed with adequate treatment. Hereby we present two cases of non-traumatic bilateral adrenal haemorrhage highlighting their management during the acute phase.Case 1: 57 year old female presented due to chest pain, palpitations and troponin rise with a background history of antiphospholipid syndrome on anticoagulation. ...

Introduction: Adrenal vascular cysts are rare, in most cases incidentally discovered during abdominal imaging for other reasons. We present a case of adrenal endovascular cyst with initial suspicious features of adrenal malignancy and subsequent management and complications.Case report: This 72-year-old male was initially admitted with a weight loss over 2 months and new onset fever and rigors and right leg pain. He was noted to have an abdominal mass. H...