Endocrine Abstracts

A 43-year-old lady with no significant PMH presented with recent onset of polyuria and polydypsia shortly after commencing an SSRI. Cranial diabetes insipidus was diagnosed on water deprivation test and good clinical response to DDAVP was seen. Anterior pituitary function was normal though prolactin elevated. MRI demonstrated a 4 mm enhancing lesion in the hypothalamus in association with a bright pituitary stalk. CXR was normal, ESR and serum ACE negative. The differential di...

Introduction: We present a case of Dunnigan Kobberling type of lipodystrophy in a young female.Case report: A 25-year-old woman presented with hirsuitism, secondary amenorrhoea, increase in neck size and reduction in breast size. On examination she had moon like facies, broad neck, small breasts and well defined male pattern musculature. Testosterone and lutenising hormone were marginally raised, serum alanine transminase was raised. Overnight dexamethas...

A 62-year-old man with insulin treated type 2 diabetes presented with atrial fibrillation. Despite anticoagulation he suffered an embolic cerebellar infarct ten days later. He was found to have abnormal thyroid function tests (TSH 7.75 mu/l, free T4 49.3 pmol/l, free T3 12.0 pmol/l). Thyroid function test analysis was repeated in a second laboratory confirming the results above. TSH was stimulated by thyrotrophin releasing hormone, confirming thyroid hormone resistance. Magnet...

Objective: To describe a novel mutation of the calcium sensing receptor gene (CaSR) in a family diagnosed with familial hypocalciuric hypercalcemia (FHH).Case history: A 62 year old man being investigated for short term memory loss was referred to us by GP for hypercalcemia found on routine blood tests. He was asymptomatic otherwise. Repeat blood tests revealed serum calcium high at 2.88 mmol/l, inorganic phosphate of 0.75 mmol/l, and normal serum PTH of...

Graves' disease, which is characterised by thyrotoxicosis and a diffuse goitre, is an autoimmune disease caused by thyroid-stimulating antibodies. The onset of Graves' disease whilst a patient is on immunosuppressive treatment is unexpected and remains a rarity.A 37-year-old Caucasian female presented to the thyroid clinic with a two week history of sweating, nausea, tremor, heat intolerance and palpitations. She was known to suffer from severe pustular ...

Background: Post menopausal hirsutism should raise suspicion of androgen secreting tumors. We present a case due to bilateral ovarian hyperthecosis with an adrenal incidentaloma.Case history: 57 year old female patient was referred to us with history of new onset hirsutism over the past 2 years. She went through menopause 6 years back. On examination she had hirsutism affecting all her body, no evidence of virilization and no organomegaly on abdominal ex...

A 63-year-old phenotypic male presented with absent testis and enlarged adrenal glands. He had attended the urology clinic for persistent microscopic haematuria. He was found to have an empty scrotum and hypospadias. The patient recalled having genital surgery in childhood but could not recall any endocrine assessment. He was taller than his peers in early childhood but stopped growing after age 13 years. He described himself as ‘potent’. He was unmarried and did not...

Introduction: Hypocalcemia in post-operative hypoparathyroidism responds to oral vitamin D and calcium replacement. We describe a case of persistent symptomatic hypocalcemia and hypothyroidism despite oral replacement and management with supervised weekly supplementation.Case history: A 56-year-old lady had total thyroidectomy for multinodular goitre. Persistent post-operative hypoparathyroidism and hypothyroidism necessitated replacement with calcitriol...

Introduction: Aminoglycoside exposure may result in hypomagnesemia, hypocalcaemia and hypokalemia. We describe a case of severe hypomagnesemia due to gentamicin therapy.Case report: A 46-year-old lady presented with ‘pins and needles’ and muscle cramps two weeks after being treated with gentamicin for biliary sepsis. Trosseau and chovstek signs were positive. Investigations showed hypokalemia, hypocalcaemia and hypomagnesemia (0.25 mmol/l (0.74...

Aim: To asses the significance of single 60 min serum cortisol level compared to conventional approach in short synacthen test (SST).Methods: Retrospective analysis of cortisol values in SST. Serum cortisol values at baseline, 30 min and 60 min were recorded. Rise of serum cortisol level to >550 nmol/l and a rise of >200 nmol/l from baseline is considered to be a negative test for hypoadrenalism.Results: About 168 patients ...