Endocrine Abstracts

Glycogen storage disease, which is a metabolic disorderof glycogen storage, affecting 1 in 20000-40000 ive births. This is a case of yound adolescent female with glycogen storage disease type1b, presented with lactic acidosis and managed in ITU.18 years old femae from Honk kong, student in a college, admitted to a dgh hospital with fever, vomiting and abdominal pain for a week. examination showed severe features of dehydratio...

The majority of clinically palpable masses affecting the thyroid are benign. Malignant thyroid tumours are the commonest endocrine malignancies yet are rare. Most are of a single distinct cellular type, though mixed cellularity tumours also occur, the commonest of which is papillary and follicular. We describe 2 cases with more than one differentiated tumour in each thyroid gland.CASE 1A 44y builder with a family history of medulla...

A 27y old woman presented with a 2yr history of secondary amenorrhoea and mild hyperprolactinaemia. CT scan demonstrated an enlarged pituitary gland abutting the optic chiasm. Goldman perimetery was normal and trans-sphenoidal hypophysectomy undertaken. Post-operatively she suffered temporary diabetes insipidus responding well to desmopressin. At endocrine assessment, she was growth hormone deficient, had partial diabetes insipidus and a sub-optimal cortisol response. Desmopre...

BackgroundA fear of rising serum prolactin concentrations (PRO) and pituitary tumour enlargement undoubtedly result in over-treatment of some patients with pathological hyperprolactinaemia. In recent years, our unit has adopted pragmatic criteria for discontinuing dopamine agonist (DA) therapy in selected patients. These include: small (or no) abnormality of pituitary imaging; presentation PRO<2,000milliunits per litre; small DA dose; stable PRO; women with a history of...

Case history: A 37-year-old female presented to her GP with myalgia, lethargy and weight gain. Of note she was 24 months post-partum and had not experienced thyroid problems in either of her two pregnancies. On examination she was overweight with marked myxoedema and proximal myopathy.Investigations: Serum TSH was greatly elevated at 206 mIU/l and free T4 was undetectable at <3.20 pmol/l. T3 was 2.8 pmol/l. She was referred urgently to the medical te...

Case history: A 35-year-old female was found to be significantly hypertensive (181/91 mmHg) following a first trimester miscarriage (at 8 weeks gestation) during her first pregnancy.Investigations: Blood tests demonstrated moderate hypokalaemia (2.6 mmol/l) with a normal serum sodium (140 mmol/l) and eGFR (>90 ml/min). ECG showed hypokalaemic changes with prolongation of the PR interval and T wave flattening. To avoid potential misinterpretation, add...

Case History: 26 year old man with uncontrolled hypertension and weight gain over the last 10 – 15 years associated with abdominal stretch marks. His past medical history includes hypertension managed with four oral anti-hypertensive agents and a BMI of 36.74 kgm2 (with centripetal obesity). There is no family history of hypertension.Investigations: However, there was historical biochemical evidence of hypokalaemia (between 2.6 – 3.2mmol/l) in ...

Case history: A 34-year-old man attended the emergency department with a history of sudden onset severe headache associated with vomiting, neck stiffness mild photophobia not relieved with analgesia. He reported a past medical history of hypertension treated with angiotensin-converting enzyme inhibitor (ACEi). There was no focal neurology, and his observations were unremarkable - blood pressure 121/64 mmHg, heart rate 54 beats per minute, respiratory rate 14 breaths per minute...

In 1981 a 33yr old woman was diagnosed with Graves thyrotoxicosis and type 2 diabetes mellitus. At diagnosis her BMI was 19 kg/m2 and she was initially treated with carbimazole and glibenclamide. She had a past medical history of idiopathic lymphoedema, asthma and bronchopulmonary aspergillosis and was regularly reviewed by an ophthalmologist for hyperpigmented maculae.In 1991 she required insulin to control her diabetes and developed progress...

In 1981 a 33 yr old woman was diagnosed with Graves thyrotoxicosis and type 2 diabetes mellitus. At diagnosis her BMI was 19 kg/m2 and she was initially treated with carbimazole and glibenclamide. She had a past medical history of idiopathic lymphoedema, asthma and bronchopulmonary aspergillosis and was regularly reviewed by an ophthalmologist for hyperpigmented maculae.In 1991 she required insulin to control her diabetes and developed progres...