Endocrine Abstracts

We present here a case of diagnostic dilemma in a 34-year female presenting with Amenorrhoea. She was recently married and saw GP for infertility and history of hot flushes, melasma and migraine. Clinic history revealed primary amenorrhoea diagnosed in Brazil at age 15. Patient was told she was born without ovaries and was started on Premarin (oetrogen). She had normal female secondary sexual charcteristics, functional female genitalia and growth. On examination, she had a nor...

A 20-year-old lady presented to her GP with menstrual irregularity and worsening right-sided headaches with associated vomiting. Blood tests showed a mildly raised testosterone level and a markedly raised prolactin level, approximately 80% of which was macroprolactin (normal monomeric prolactin level). She was subsequently referred by her GP for an MRI Pituitary, which was reported as showing a 6-mm hypoenhancing lesion. Medical history includes migraines and hayfever; she was...

The circadian clock is a key regulator of immune responses. Both circulating and resident immune cells possess intrinsic timers, which act to impart time-of-day variation in their function. It is now becoming evident that the circadian clock is also critically involved in regulating the function of endogenous anti-inflammatory glucocorticoid hormones. Consequently, we see variation in an animal’s inflammatory responses dependent on the time the stimulus was delivered. Thi...

Background: In 2014, Thy002 (the proportion of patients with hypothyroidism on the practice register with thyroid function tests recorded in the preceding 12 months) was removed as a Quality Outcome Framework (QOF) target.Aim: To audit the current management of hypothyroidism in primary care two years following the QOF changes.Method: Four local practices (total patient population: 37 200 (range 7300–1300 per Practice)) partic...

Introduction: Despite the usefulness of using theory to underpin analysis, there is a paucity of literature applying this to experiences of gastric banding (GB) surgery. The Theory of Planned Behaviour (TPB) is useful for exploring beliefs underlying behaviour. The present study uses a TPB framework to explore individuals’ beliefs towards GB both prior to and five years post-surgery.Methods: A prospective longitudinal qualitative study. Semi-structu...

A 61-year-old man presented to his primary care service with complains of frequent hot flushes, dizziness and headache. Following initial screening, an incidental pituitary lesion was diagnosed on computed tomography (CT) scan and hence was referred to specialist review. Further detailed history revealed similar presentation with dizziness and hot flushes two and a half years ago. He was then diagnosed with essential hypertension after a negative work-up for Cushing disease. H...

Familial Benign Hypocalciuric Hypercalcaemia (FBHH) is a benign autosomal dominant condition characterised by elevated serum calcium and parathyroid hormone (PTH) and low urine calcium. It is a genetically heterogeneous disorder but the majority of cases (type 1 FBHH) can be shown to be due inactivating mutations in the Calcium Sensing Receptor (CASR). This is a guanine nucleotide-binding-protein (G-protein) coupled receptor that signals through the G-protein subunit α11 ...

Case report: A 29-year-old female with a 17-year history of severe enduring anorexia nervosa attended our unit. Osteoporosis was diagnosed aged 24 and she had developed a left calcaneal fracture after minimal trauma 3 weeks prior to presentation. Her bone mineral density at this time confirmed the presence of osteoporosis at the lumbar spine and total hip (T-score −3.3 and −2.9 respectively) and her body mass index was low at 15.1 kg/m2. She dec...

Introduction: We present a case of a gentleman with non-islet cell tumor hypoglycemia (NICTH), a rare cause of spontaneous hypoglycemia that presents clinical challenges in maintaining euglycaemia.Case report: A 76-year-old gentleman not known to be diabetic presented with confusion and agitation. On admission he had a blood glucose reading of 2.1 mmol/l and clinical examination confirmed an abdominal mass. He was initially resuscitated with i.v. dextros...

Introduction: Langerhans cell histiocytosis (LCH) is a rare multisystem disease. Pituitary manifestations include failure of the anterior and/or posterior pituitary, with diabetes insipidus and gonadotrophine deficiency being most prevalent. We present a case of a female who had pituitary failure yet conceived naturally following chemotherapy.Case description: A 24-year-old female presented with polydipsia, polyuria, and lethargy. A water deprivation tes...