Endocrine Abstracts

We report a rare case of 37 years female of Greek and Irish extraction with a history of thalassemia trait, who presented with generalised weakness and severe loin and pelvic pain 9 days post vaginal hysterectomy and 3 days after hospital discharge. After readmission, she developed mild pyrexia (37.5°C), hypotension, mild hyponatraemia with plasma sodium which fell from 138 to 131 mM and early signs of acute respiratory distress syndrome. A Short Synacthen test was perfor...

Background and aims: Subjects with primary (PAI) and secondary adrenal insufficiency (SAI)/hypopituitarism have an increased cardiovascular mortality for reasons that are unclear. Arterial stiffness is an independent risk factor for increased cardiovascular mortality. We sought to measure arterial stiffness in subjects with AI and aimed to identify which factors might account for any increase observed.Methods: Ethical approval was obtained for this study...

Aims: Endocrine Society (ES) acromegaly guidelines (2014) addressed complication screening. Uncontrolled acromegaly is associated with elevated cardiovascular mortality due to risk factors including hypertension (HT), diabetes mellitus (DM), obstructive sleep apnoea (OSA), and with an increased risk of colorectal cancer and polyps among other types of neoplasias. We audited our clinical practice with regards to acromegaly complication screening.Methods: ...

Aim: Endocrine Society (2016) published guidelines for hormonal replacement in hypopituitarism. Central hypothyroidism (CH) is defined as fT4 below reference range and mild CH is defined as fT4 in the low-normal range with suggestive symptoms in the context of pituitary disease. In patients with panhypopituitarism levothyroxine in doses sufficient to achieve fT4 levels in the upper half of the reference range is recommended. In our centre...

Aims: Endocrine Society (ES) acromegaly guidelines (2014) addressed complication screening. Uncontrolled acromegaly is associated with elevated cardiovascular mortality due to risk factors including hypertension (HT), diabetes mellitus (DM), obstructive sleep apnoea (OSA), and with an increased risk of colorectal cancer and polyps among other types of neoplasias. We audited our clinical practice with regards to acromegaly complication screening.Methods: ...

Aim: Endocrine Society (2016) published guidelines for hormonal replacement in hypopituitarism. Central hypothyroidism (CH) is defined as fT4 below reference range and mild CH is defined as fT4 in the low-normal range with suggestive symptoms in the context of pituitary disease. In patients with panhypopituitarism levothyroxine in doses sufficient to achieve fT4 levels in the upper half of the reference range is recommended. In our centre...

Case history: A 27-year-old woman presented with a 48 hour history of lethargy, nausea and myalgia. Twelve days earlier she had given birth to her first child. Her daughter was born at term following an uncomplicated pregnancy. She had no abdominal pain or vaginal discharge and her episiotomy wound was well healed. She had no significant past medical history, took no regular medications and did not drink alcohol. There was no significant family history. On arrival in the emerg...

Case history: A 61 year old male with a background of diabetes mellitus Type 2 and congestive cardiac failure (CCF) was diagnosed with Cushing’s disease in 2014 following identification of severe osteoporosis through investigations for non-traumatic vertebral fractures causing paraplegia.Investigations: He had high ACTH and cortisol levels which failed to suppress on low and high dose dexamethasone suppression tests, hypogonadotrophic hypogonadism a...

Case History: A 69-year-old gentleman was admitted having lost consciousness. This episode was preceded by typical hypoglycaemic symptoms which, in retrospect, he had experienced for four decades with increasing frequency and severity over the past year. He was hypertensive. There was no family history of endocrinopathy or diabetes.Investigations: A supervised inpatient fast was undertaken along with cross-sectional and radio-isotope imaging.<p class...

Case history: We report a 56-year-old man who was referred to the Endocrinology Clinic with hypokalaemic hypertension. He had a history of bladder cancer 9-years previously, treated with surgery, chemotherapy and BCG therapy. At referral, he was taking Amlodipine 10 mg and Doxazosin 8 mg twice daily with average home blood pressure readings of 160/90 mmHg.Investigations: Aldosterone to renin ratio (ARR), taken on Doxazosin with potassium 3.6 mmol/l was 3...