Endocrine Abstracts

Induction of puberty may be required in boys, if puberty is either delayed or arrested. Boys with delayed puberty are often significantly concerned about their physical immaturity, short stature and perceived difference in appearance from peers. The commonest cause of delayed puberty is constitutional delay of growth and puberty (CDGP), a relatively benign condition. However, hypergonadotrophic hypogonadism due to Klinefelter syndrome and hypogonadotrophic hypogonadism (HH) du...

A 41 year old lady was referred to the endocrine clinic by her respiratory physician. She is known to have Langerhans cell histiocytosis (LCH) with lung involvement. She is having yearly follow up under respiratory team and not needing any treatment for LCH. In endocrine clinic she confirmed that she is drinking around 9 to 10 L of water / day and having quite significant polyuria. She works in Tesco. She does not have any other medical condition and not taking any regular med...

A 71 year lady, who has past history of acute ischaemic stroke ( now bed bound and can only get out of bed with the help of a hoist) , Type 2 diabetes melitus, HTN, CKD and high lipid. She is on Metformin 1 gm twice daily, Ramipril 5 mg at night, Clopidogrel 75 mg od, Atorvastatin 80 mg od. She was brought to hospital by unexplained drowsiness and poor oral intake. Her blood sugar was 72, ketone 5.2, Ph: 7.21, Na: 165, Urea 14 and calculated osmolality of 412. Her chest xray a...

Background and objectives: Ineffective communication is one of the leading causes of medical errors and patient dissatisfaction. We implemented an initiative for dynamic endocrine tests to enhance communication with primary care colleagues and patients.Methods: We introduced a comprehensive system of organising dynamic tests, structured documentation, weekly endocrine meeting to discuss the results and standardised escalation process for suspected abnorm...

Introduction: Trimethylaminuria or Fish Odour syndrome is a rare genetic metabolic disorder. It can cause significant suffering to affected individuals due to social isolation and stigma. It is under recognised and ignored.The case: A 60 years old lady was referred by her GP. The referral – ‘She feels she has a problem with personal hygiene and is aware of an odour from her skin, her breath and urine.’ This lady has been suffering from thi...

Introduction: Adrenocortical carcinomas are rare aggressive tumors. 36 % of patients with ACC have distant metastasis on presentation. Although lung metastasis are commonly seen in metastatic Adrenocortical carcinoma, cannonball pulmonary metastasis which are solid and well circumscribed parenchymal masses of variable size are rare and typically seen in Renal cell carcinoma and also in other cancers such as bone sarcomas. We report a case of functional Adrenocortical cancer wi...

A 29-year-old pregnant lady known hypothyroid for 5 years, presented with thyroid eye disease (TED). She is a non-smoker. Her TFT in the past years has been stable.Her exophthalmos was noticed at early pregnancy. Her anti-thyroid peroxidise antibodies (TPO-Ab) were >1300 mU/l (ref. range <1.4) and TSH-R antibodies (TRAB) were 18.6 U/l (ref. range <5.0).On presentation she was clinically and biochemically euthyroid with ...

Aim: To present a case of a 54 year old gentleman presenting with polyuria and diagnosed with cranial diabetes insipidus.Methods: The case history, including, detailed results of laboratory tests are presented, and the findings are discussed.Results: Way back in October 2004 Mr Z.A. was referred to the ENT surgeons with hearing difficulties in the right ear. He was diagnosed with catarrhal otitis media and chronic rhinitis. Symptom...

ACTH insensitivity syndromes comprise a rare, and underrecognised, group of disorders, which include familial glucocorticoid deficiency (FGD) and triple A or Allgrove syndrome (ACTH insensitivity, alacrima, achalasia and neurological involvement). They are characterised by undetectable cortisol and very high circulating ACTH with resultant hyperpigmentation and are inherited in an autosomal recessive manner. Distinction between FGD and triple A syndrome may be difficult and is...

ObjectiveTo describe a few cases of patients presenting with various unusual causes of hypercalcaemia to a District General Hospital.MethodsThree case histories, including detailed results of laboratory tests, are presented, and the findings are discussed.ResultsIn the first case we describe an eighty year old patient recently started on lithium carbonate for mani...