Endocrine Abstracts

Case history: A 70 years old man with longstanding resistant hypertension on five antihypertensive agents, type two diabetes and raised BMI at 35.6 was referred to the endocrinology clinic for exclusion of possible Cushing’s disease. Clinically he had truncal obesity with plethoric face but no telangiectasia, easy bruising, purple striae or myopathy.Investigations: Endocrine examinations revealed normal 24 h urine free cortisol levels on two separat...

The patient now aged 28, was seen at the age of 8 years by an ophthalmologist when he fell down stairs and complained that he could not see from his right eye. He was confirmed to have optic disc hypoplasia in his right eye with acuity of 2/60. A CT scan of his head was reported normal. He was also short statured with his height being on 3rd centile. He was suspected to have partial growth hormone deficiency on the basis of insulin tolerance test and patient was placed on grow...

Patients who have Sr. Prolactin level >3000 mU/l (n=24) were selected from the Biochemistry laboratory record & patients with confirmed diagnosis of prolactinoma (n=33) identified and / followed up at Endocrine Clinic between December 1999 and October 2001 were studied. The mean age of the patients were 45.03+ 14.09 years and 72% were women. Of the patients diagnosed to have prolactinoma, 16 had microprolactinoma. 16 had macroprolactinoma and 1 had stalk disconnection. ...

The diagnosis of Pheochromocytomas often poses a great challenge. We report a case of pseudo-pheochromocytoma causing challenges in the clinical diagnosis. A 35-year old gentleman with high BMI, was admitted with worsening headache, visual field defects and accelerated hypertension. MRI pituitary and biochemical profiling revealed a non-functioning pituitary macroadenoma with optic chiasm compression, warranting urgent surgical intervention, vindicating an endocrinology referr...

Hyponatraemia in pregnancy can be precipitated by various factors, including drugs, fluid excess and oxytocin infusion. It is a common complication of pre-eclampsia toxaemia (PET), although concomitant syndrome of inappropriate ADH secretion (SIADH) in this context is rare. We present a case of SIADH leading to hyponatraemia in a PET patient. A 30 year-old primigravid woman with bipolar disorder and hypertension was admitted with pre-eclampsia at gestational week 28. Her medic...

Introduction: PSIS is a rare congenital abnormality characterised by a triad of thin or interrupted pituitary stalk, small or absent anterior pituitary, and an absent or ectopic posterior pituitary gland. Incidence is around 0.5/100 000 births. Clinical presentation varies according to age. We herein describe two cases of PSIS diagnosed in the early infantile period.Case 1: A term female neonate born by emergency section...

Background: The Ultrasonography (USS) and Tc-SestaMiBi (MiBi) scans are established tests to localize parathyroid adenoma. It is important to utilize these appropriately prior to surgery for a positive outcome.Method: It was a retrospective study in patients diagnosed with primary hyperparathyroidism (PHPT) according to the NICE Guideline who underwent parathyroidectomy from 01/01/2015 to 31/12/2019. We aimed to assess the USS and Tc-Sestamibi scan’...

A 55 year-old Nepalese lady, previously fit and well, presented to her GP 2 months ago with palpitations and weight loss. She was diagnosed with Graves thyrotoxicosis based on her clinical history and biochemistry, and was started on carbimazole 40 mg daily. She suffered from COVID19 infection a month later and started self-isolating. She continued to feel unwell for three weeks but did not seek urgent medical attention due to the perceived general recommended isolation guidel...

39-year-old female, with a past medical history of Graves Hyperthyroidism, underwent total thyroidectomy 18 years ago, with resultant hypoparathyroidism, hypocalcaemia and hypothyroidism. Her calcium levels are usually in the range of 1.6-1.8 mmol/l, but there are times when it can go to dangerously low levels (range of 1.4-1.15 mmol/l) causing symptoms, sometimes with ECG changes, requiring hospital admissions and IV calcium replacements. There is no parathyroid activity dete...

A secondary hypertension service was set up by the Endocrinology team in 2016 aiming to capture young hypertensive (age <30 years), refractory hypertension and hypertensive emergency to provide holistic care. A pathway was developed streaming Hypertensive emergencies to the high dependency area for intravenous treatment and hypertensive urgencies to the Ambulatory care for oral medications. All patients were linked to a secondary hypertension clinic. Staring with one clini...