Endocrine Abstracts

A 45-year-old male to female transsexual presented with poor female fat distribution. She had been treated with oestrogen for 13 years, initially as ethinyl oestradiol to a maximum dose of 150 ug/day, presently taking 100 mcg with GNRH analogue. On this regimen she had B cup breast development but underwent breast augmentation surgery and still suffered from low self-esteem. She was dissatisfied with her body image because she perceived a male body fat distribution. Her initia...

A 39-year-old man was referred to our department with an incidental finding of low blood glucose. He had presented to rheumatology with non-traumatic left knee pain and swelling. He had a longstanding history of obstructive sleep apnoea and hiatus hernia. He had not been taking any medications. Examination was unremarkable apart from tender left knee with an effusion. A diagnosis of reactive arthritis was made. An incidental finding of low blood glucose (2.7 mmol/l-normal 3.4&...

Aim: To study those factors which influence the sensitivity and positive predictive value of combined MIBI scintigraphy and ultrasound scan in the localisation of parathyroid adenomas.Method: A retrospective review of notes was done of 150 patients with hypercalcaemia referred to the Endocrine outpatients’ clinic, between the years 2002–2005.Notes of 135 patients with biochemical evidence of primary hyperparathyroidism (P...

ObjectivesTo compare our practice, at Sunderland Royal Hospital, to the recommendations of NIH Consensus Development Programme (February 2002) and BAES.MethodRetrospective audit of patients who had adrenal mass on imaging studies done between 1996–2004.Patients who had incidentally detected adrenal mass were included. Patients with symptoms and / or signs suggesting adrenal mass pr...

An 82-year-old lady admitted after multiple episodes of collapse and her blood sugar levels were noted to be less than 2.0 mmol/l. A supervised controlled fasting test was performed and results were consistent with Insulinoma. Imaging revealed a mass in the tail of the pancreas with metastasis to the liver. Liver biopsy confirmed the diagnosis of a poorly differentiated neuroendocrine tumour. She continued to have hypoglycaemic episodes which were difficult to manage. Dietary ...

32 year old female with no prior past medical problems presented to hospital with a two week history of rapid onset delusional psychosis with religious themes, paranoid ideas and rapidly developing into catatonia. There was no previous history of psychiatric disorders. On physical examination the Glasgow Coma Score (GCS) was 15 and she was responding to visual hallucinations; speaking to imaginary person and reported seeing objects. She was afebrile and bedside observations we...

Introduction: Pathological fractures are uncommon in young patients and raise concern about malignancy. Brown tumour (osteitis fibrosa cystica) is a rare benign resorptive bone lesion reported in approximately 3% of patients with primary hyperparathyroidism (PHPT). These have become uncommon in contemporary practice and have the potential to be misdiagnosed because of radiological similarities to other bone diseases especially malignancy.We present a case where the first prese...

Introduction: The role of vitamin D and calcium metabolism has long been implicated in the clinical manifestation of primary hyperparathyroidism (PHPT). The skeletal response to the overproduction of PTH is less predictable, and the effect on bone loss can be greater in some patients. In this study, we established associations between vitamin D metabolism, vitamin D metabolite ratio (VMR) 1,25OH2D:24,25OH2D with rates of bone loss in PHPT patients who did not undergo surgery.<...

Introduction: Graves’ disease (GD) has a well-known association with thymic hyperplasia caused by TSHR expression in thymus and regresses by approximately 33-90% with treatment. Splenomegaly due to lymphoid hyperplasia has also been linked with GD in about 10% patients. Cerebral venous sinus thrombosis (CVST) linked with GD is documented in literature but is more common occurrence in solid cancers.Case presentation: We report a case of 32-year man a...

The pituicytomas are extremely rare and little-studied primary tumours of the adult neurohypophysis. These are low-grade (World Health Organization [WHO] grade 1), indolent gliomas which present as a sellar mass, which is usually mistaken for a pituitary adenoma, and has no known hormonal secretory function. A 63 years old retired paediatrician was referred to the neurology clinic with the history of constant severe headache ongoing for a few weeks. It involved the whole of th...