Endocrine Abstracts

We present a case of a 29-year-old lady who presented with subfertility. She had had a 2 years history of oligomenorrhoea with highly irregular menses. She had symptoms of depression and described tunnel vision. Clinically, she was euendocrine with no features of hormonal excess or deficiency. She was not hirsute. Visual field testing demonstrated a severe left superior temporal quadrantopia.Laboratory investigations demonstrated an oestriadol level rang...

Background: Arginine Vasopressin Deficiency [AVP-D] can occur as consequence of any abnormality or injury at one or more of the sites involved in the Antidiuretic hormone [ADH] secretion. AVP-D is one of the presenting features of suprasellar lesions with panhypopituitrism. The natural course of the disease differs based on the underlying aetiology. It is likely to be transient post-operatively. Idiopathic DI is usually permanent however DI can be reversible w...

Idiopathic infantile hypercalcemia (IIH) (OMIM 143880) is characterised by severe hypercalcemia, failure to thrive, vomiting, dehydration and nephrocalcinosis. Laboratory evaluation of infants affected with this condition reveals hypercalcemia, suppressed parathyroid hormone and hypercalciuria. Recently loss of function mutations in CYP24A1 gene have been found to cause IIH (New England Journal of Medicine 2011 365 410–21). Short-term treatment for th...

Medullary thyroid cancers (MTC) account for about 5% of thyroid cancers. The biochemical hallmark of MTC is the secretion of calcitonin (CT). CT levels are both a key feature of pre-operative diagnosis and post-operative follow up. CT screening in a cohort of over 10 000 patients with thyroid nodular disease has demonstrated that a positive CT test has a higher diagnostic sensitivity and specificity for MTC than fine needle aspiration (FNA). They may also secrete carcinoembryo...

Background: Chromaffin cell tumours are rare but potentially curable endocrine tumours. These tumours may be sporadic or familial in nature. Biochemical tests are normally performed initially, followed by radiological investigation.Aim: To assess the correlation of biochemical and radiological investigations with histologically proven chromaffin-cell tumours in patients with sporadic and familial disease.Methods: We retrospectively...

A 33-year-old lady presented to the surgeons with history of abdominal pain. CT scan abdomen done revealed massive adrenal enlargements reported as adrenal myelolipomas (left gland measuring 8.0×10.9×11.8 cm and multifocal lesions on the right with the larger one measuring 5.2×4.3×3.6 cm). She was referred to the endocrinology team where further history was elicited. She had been diagnosed as a child to have congenital adrenal hyperplasia (CAH) but was lost...

Aim: In the thyrotoxicosis local investigation protocol, Tc99m pertechnetate scintigraphy technetium scan is used to assess the presence of thyroid uptake and both the degree and pattern of uptake. TSH receptor antibodies are used to demonstrate the presence and activity of autoimmune thyroid disease. We audited the utility of these investigations in a series of thyrotoxic patients.Methods: Forty-nine patients (11 men, 38 women, mean age 47.5±38) we...

Background: Although hypocalcemia is common post thyroidectomy, no national guidelines pertain to its management.Long-term treatment with calcium and vitamin D replacement predispose patients to nephrocalcinosis and should be avoided in the absence of a clear indication.Aim: To identify the incidence and management of post-operative hypocalcemia following thyroidectomy in a UK teaching hospital with view to formulating management g...

We describe the case of a 70-year-old lady presenting with marked, symptomatic hypercalcaemia.Past medical history was of insulin-treated Type 2 Diabetes, macrovascular disease and chronic renal impairment.On admission, corrected calcium was noted to be 3.53 mmol/l with a paired PTH within normal range (4.3 pmol/l, range 1.6–9.3). Further questioning revealed a history of weight loss but no other clinical features specifically...

Background: Adreno cortical carcinoma (ACC) is a rare malignancy associated with aggressive biological behavior and poor outcome. The reported incidence in literature is about approximately two cases per million population’s.These tumors might be functional or non-functional depending on their ability to secrete various adrenocortical hormones. ACC occurring in children and adults show distinct characteristics and there is not much literature regarding the differences. Si...