Endocrine Abstracts

A 68 year old gentleman referred to endocrinology clinic with a few years history of erectile dysfunction (ED), which manifested as reduced libido and partial erections. Investigations revealed primary hypogonadism with a low morning serum Testosterone of 4.8 (Ref: 7.9-31 nmol/l), raised FSH at 47 (Ref:1.5-12.4 iu/l) LH at 36.8 (Ref: 1.7-8.6iu/l) and normal thyroid function tests (TFTs). The patient declined testosterone replacement therapy following a discussion of pros and c...

Background: SGLT-2 inhibitors (SGLT-2i) are used in treatment of type 2 diabetes mellitus (T2DM) through increasing urinary glucose secretion. Cases of euglycemic and hyperglycaemic diabetic ketoacidosis (DKA) have been reported in literature in patients using SGLT-2i. Increased glucose urinary excretion promoted by SGLT2i, decreases the production of insulin. In turn, lipolysis and ketone production increase predisposing the patient to developing DKA. It is hypothesised that ...

Thyroid storm is rare life-threatening clinical manifestation of endocrine dysfunction originating from excess level of thyroid hormone leading to hypermetabolic state with an incidence of 0.57-0.76/1000,000. The increase demand of metabolic activity subsequently induces, palpitations, dyspnoea, exercise intolerance and congestive heart failure. Most common cardiovascular manifestation of thyroid storm is tachycardia and atrial fibrillation occurs in up to 15% of patients. In ...

Myxoedema Coma with NAFLD secondary to poorly controlled hypothyroidism. Myxoedema coma is defined as severe hypothyroidism leading to decreased mental status, hypothermia, and other symptoms related to slowing function in multiple organs. It can culminate in severe, longstanding hypothyroidism or be precipitated by acute stressors such as infection, and surgery in patients with poorly controlled hypothyroidism. Moreover, there is a strong correlation between poorly controlled...

Background: A thyroid nodule is a discrete lesion within the thyroid gland, which can serve as a prelude to a spectrum of conditions ranging from a benign incidental growth to a full-blown invasive carcinoma. Thyroid nodules are very common in adult population. About 15% of the UK population have clinically detectable goitres or thyroid nodules, and the lifetime risk of developing a thyroid nodule is around 5 to 10%. In addition, there is increasing risk of thyroid cancers in ...

Hypothyroidism due to autoimmune aetiology can be associated with other autoimmune conditions such as Type 1 Diabetes Mellitus (T1DM) and primary adrenal insufficiency. Ruling out primary adrenal insufficiency is important in any patient with suspected autoimmune hypothyroidism.Case: 43-year-old female complaining of general lethargy, sore throat, and neck pain. She was found to be hyponatraemic (Na+ 130) after being reviewed by the GP and was advised to...

Background: Autoimmune polyglandular syndrome type 2 is an autoimmune disorder that affects many hormone-producing (endocrine) glands. It is characterized by the presence of Addison’s disease along with autoimmune thyroid disease and/or type 1 diabetes. The initial presentation can be varied but some patient maybe present with subclinical hypothyroidism and later develop Addisonian crisis. The pathogenesis of Autoimmune polyglandular syndrome type 2 remains unclear, altho...

Background: Starvation ketoacidosis (SKA) represents one of three metabolic acidosis caused by the accumulation of ketone bodies in blood. While easily treated, it is a diagnosis that can be easily mimic diabetic ketoacidosis, particularly in the presence of hyperglycemia1.Case: We report a 54-year old female, who had been feeling unwell with ongoing nausea and vomiting, and not eating nor drinking for 5 days. She had a history of alcohol exce...

Introduction: We present two pregnant women who were referred to obstetric endocrinology service with polyuria and polydipsia. They were investigated and treated for diabetes insipidus (DI). In both cases, the underlying pathophysiology was ADH insufficiency secondary to autoimmune lymphocytic hypophysitis. There are currently no consensus guidelines on the diagnosis of DI during pregnancy. These cases highlight best practice and endorse MDT management of chronic hypopituitari...

Introduction: Background: Pituitary adenomas can be divided into functioning pituitary adenoma (FPA) and non-functioning pituitary adenoma (NFPA). Pituitary adenomas can also be classified based on their size as microadenoma(<1cm) or macroadenoma (>1cm).Cases: 1. A 33-year male was admitted with a 4-month history of headaches, generalized aches and pains, weight loss, lethargy, and erectile dysfunction. He was reviewed by t...