Endocrine Abstracts

Congenital isolated hypogonadotropic hypogonadism (CHH), is a condition characterized by a defect in development, migration and action of GnRH neurons. Numerous genes are involved in CHH. It can present with anosmia, hyposmia or normosmia. Two cases presented to our department with late onset delayed puberty. First case was a 29 year old with absence of secondary sexual characters along with micropenis and anosmia. His younger brother, 22 year old had similar complain...

We present the case history of a 33-year-old male with Noonan syndrome diagnosed at 2 months of age, as he had typical facial features (hypertelorism, ptosis, low set ears, and small pointed chin), a heart murmur and bilateral cryptorchidism. At 22 months he underwent patent ductus arteriosus closure and at 24 months, the left testis was excised, for testicular torsion. He had learning difficulties and attended a special needs school and was intermittently reviewed in the paed...

Background and aim: The Department of Health and NHS Plan both recognise that sending patients copies of clinic correspondence can help inform and empower them. At St Helens and Knowsley Teaching Hospitals NHS Trust, Endocrinology Clinic we routinely provide patients with a copy of the clinic correspondence sent to their General Practitioner (GP), unless patients specifically opt out. Our aim was to evaluate patients’ views on receiving such copy correspondence following ...

Introduction: Hyponatraemia is the commonest electrolyte disturbance occurring in 15–20% of inpatients (1), with significant clinical implications if mismanaged. We conducted a retrospective audit of our current management of hyponatraemia in our 1000 bedded trust.Method: Data of patients with severe hyponatraemia (Na<125 mmol/l) admitted to hospital over 4 weeks (Aug 2011) was collected. Twenty randomly selected cases were reviewed focusing on ...

Male hypogonadism is usually considered in the presence of classical symptoms like reduced libido, erectile dysfunction and reduced bone mineral density.We present the case history of a 43-year-old man with learning difficulties who presented with long-standing lethargy. Clinical examination revealed bilateral ptosis, muscle weakness and slow relaxation of handgrip. He had abdominal obesity, pseudo-gynaecomastia, frontal balding, reduced facial, chest, a...

Background: Male hypogonadism is associated with reduction in bone mineral density (BMD). This study aimed to determine the epidemiology of low BMD in a clinic-based cohort of hypogonadal men.Methods: This was a retrospective, cross-sectional observational study of 152 patients (≥18 years with testosterone(T) ≤11 nmol/L) who were consequently reviewed in an endocrine clinic. Data was extracted from electronic patient records and included base...

Background: In primary hyperaldosteronism (PHA), CT is the sensitive imaging to visualise adrenal adenoma. However, because of the high incidence of adrenal incidentalomas, adrenal venous sampling (AVS) is frequently required to indentify unilateral (UD) or bilateral (BD) disease. AVS can be technically difficult and result can be operator dependant.Method: We retrospectively reviewed the last 14 cases of AVS performed in our hospital. The criterion of U...

Thyroid nodules are common, but the incidence of thyroid cancer occurring within them is very low. Nonetheless, patients presenting with thyroid lumps are frequently worried that they have cancer, and the wait for a diagnosis to be confirmed or refuted is highly stressful. This presents challenges to the clinician, in determining who requires extensive investigations, and how best to reassure patients in whom this is not indicated. However, satisfied patients are more likely t...

A 33 year old male presented with a two year history of fatigue, headaches, loss of libido, insomnia, depression and hypertension. On examination, he was floridly Cushingoid with central obesity, proximal muscle weakness and purple striae. A bilateral temporal, superior quadrantanopia was noted on formal perimetry. Investigations revealed markedly elevated prolactin levels at 56560mIU/L, hypogonadotropic hypogonadism and secondary hypothyroidism. He also had elevated urinary c...

Background: Male hypogonadism is commonly caused by hypothalamo-pituitary testicular disease. The effect of modifiable risk factors (obesity, alcohol, smoking, prescribed medications and recreational drugs) on secondary hypogonadism in a clinic-based cohort is unclear. The aim of this study was to ascertain the prevalence and effects of modifiable risk factors on secondary hypogonadism.Method: This was a retrospective, cross-sectional observational study...