Endocrine Abstracts

Background: Ovarian granulosa cell tumours are rare, aggressive, hormonally active neoplasms.Case: A 16-year-old, nulliparous, Eastern European woman presented with a 9-month history of secondary amenorrhoea and a 2-month history of galactorrhoea. She denied headache or visual symptoms. Past medical history was unremarkable with menarche at age 14 and a previously normal menstrual cycle. She had never used hormonal contraception. Only medications were pa...

Background: This project endeavoured to improve the quality of endocrinology teaching to clinical medical students through the use of a new multi-stage process.Methods: We created a co-ordinated block containing 4-h teaching sessions (4×1 h) in which eight students in their first clinical year presented answers to questions based on clinical endocrinology cases they had seen and selected. The process started with identification of cases in the out-p...

Background: Cushing’s syndrome derived from paraneoplastic ectopic ACTH production can present in dramatic fashion. We describe such a case that presented with severe hypokalaemia, involving significant diagnostic and management challenges.The case: A 66-year-old female was referred acutely to hospital by her GP after feeling weak and lethargic. She had profound hypokalaemia of 1.5 mmol/l (3.5–5.3) with normal renal function and had been normok...

A 21-year-old woman presented in 2015 with palpitations, weight and hair loss, mood swings and diarrhoea. She was diagnosed with thyrotoxicosis (Table). On examination, thyroid was normal and no evidence of opthalmopathy. Treatment with Propranolol and Carbimazole was commenced.  Ultrasound neck revealed moderate diffuse enlargement of the thyroid with uniformly abnormal echotexture, consistent with thyroiditis.  A month later, she developed profound hypothyroidism, therefore Carbimazole was ...

Carcinoma showing thymus-like differentiation (CASTLE) is a rare malignancy, localized in the thyroid parenchyma. As far as we know, only a few CASTLE cases are described in literature. The diagnosis is based on immunoreactivity, the main characteristic is positivity to CD5, which reveals a thymic differentiation. We report the case of a 63-years-old male, who presented with a 3 cm solid, hypoechoic nodule in the lower part of the left thyroid lobe, with underlying structures ...

Introduction: Hyponatraemia is one of the most common electrolyte abnormalities seen in clinical practice [1] and can be caused by a myriad of aetiologies.Aim: To report two cases of severe hyponatraemia caused by different aetiologies.Case report: A 56-year-old male patient was admitted with 2 episodes of tonic-clonic seizures at his care home. The patient had a background of small cell lung cancer and brain metastases in late 202...

Ipilimumab, pembrolizumab, and nivolumab – novel immune checkpoint blockade drugs – are increasingly used in the treatment of metastatic melanoma and other cancers. Ipilimumab is an anti-cytotoxic T-lymphocyte antigen 4 (CTLA4) MAB and the first drug shown to improve overall survival in metastatic melanoma. Hypophysitis is a widely described side-effect linked with both lymphocytic inflammation and a direct toxic effect on the pituitary in mouse studies, but has been...

Introduction: We present a case which highlights the complexities of managing hyperthyroidism.Case report: An 81 year old man complained of irritability, insomnia, diarrhoea, shortness of breath and weight loss. Past medical history includes type II diabetes, atrial fibrillation (AF), hypertension, gallstone pancreatitis requiring cholecystectomy (2005). Clinically, he was in fast AF and right heart failure. On examination he had a tremor; normal sized t...

We report the case of a 26 year old man who presented to his GP with infertility; biochemical investigations revealed elevated serum free thyroid hormones (FT4 41 pmol/l (12–22); FT3 13.4 pmol/l (2.8–7.1); and a normal TSH (2 pmol/l (0.27–4.2). He was referred to the endocrine department.On examination, he was found to be clinically well though thin (BMI 18), anxious and tremulous. His heart rate was 110 bpm and blood pressure was normal. ...

IntroductionThe mechanism by which hypertrophy of skeletal muscle occurs in response to anabolic androgens is incompletely understood. This study used a cell culture model of human skeletal muscle-derived cells, with samples obtained from consenting subjects and local ethics committee approval. The objective was to determine changes in myogenicity upon exposure to exogenous androgen +/− IGF-1 and to see whether an additive effect would be observed....