Endocrine Abstracts

A 26-year-old woman presented to the Endocrine clinic with features of Cushing’s syndrome (CS). Investigations revealed a non-suppressible cortisol in low dose Dexamethasone suppression test with a suppressed ACTH, and two positive 24-hour urine cortisol collections, indicating CS. CT imaging revealed a left adrenal adenoma of 3.4 cm. Following a left adrenalectomy, she was discharged on once daily Prednisolone 3 mg. She was well for a year except for one occasion where s...

Background: Hypogonadotropic hypogonadism (HH) is one of the few treatable causes of male infertility; spermatogenesis induction can be achieved with gonadotrophins or pulsatile GnRH. Treatment protocols are normally long, and outcome varies according to the underlying aetiology, age of onset and history of undescended testes. Regular follow-ups are needed to assess the response and monitor for adverse effects of therapy that could make the management challenging.<p class=...

Adrenal lesions are commonly detected incidentally during cross-sectional imaging examinations, and the majority are benign adrenal adenomas. A 52 year old gentleman with a history of hypertension and paroxysmal atrial fibrillation was referred to our service following a fall in which he fractured several ribs. Subsequent abdominal CT revealed an incidental finding of bilateral adrenal masses, reported as approximately 5 cm and 4 cm on the right and left side respectively with...

Case history: 36 years old, 14 weeks pregnant lady was referred to endocrinology department by GP urgently with corrected Calcium CCa of 2.97 mmol/l and normal parathyroid hormone (PTH). Her symptoms were urinary frequency and nausea. She had 3 previous miscarriages and 2 normal births. She was on folic acid and vitamin D supplements. There was family history of type 2 diabetes and B12 deficiency. Her 6 family members had normal calcium levels.Investigat...

Case: A 46-year-old woman was initially investigated for right sided intermittent headaches for one year. Her MRI head revealed a pituitary adenoma. She had no history of vomiting with the headache episodes and had no history of visual acuity or field defect. She had amenorrhoea for the past 10 months. Prior to this, she had regular periods following her menarche at the age of 12 years. She admitted to easy bruising but had no hirsutism or acne. She did not report any weight g...

We here report the cases of two patients receiving glucocorticoid replacement, whose treatment has been guided by serum prednisolone measurements and whose day curves are presented below. Ms B was a 33-year-old patient who presented 3 years ago with panhypopituitarism following transsphenoidal surgery in 2012, for a sellar mass in a foreign country. She had already commenced 5mg prednisolone daily in addition to DDAVP, levothyroxine and the COCP. Having noticed mild weight gai...

A 59 year old man was referred to our endocrine service for persistently elevated prolactin levels. He did not report any headache, visual disturbance or galactorrhoea. He was diagnosed with schizophrenia in 1994 and was tried on different antiphychotic drugs until established on a combination of Amisulpride and Clozapine 11 years later. For the past years, his prolactin levels had been elevated ranging from 1477 to 1972 milliunit/L [60–300]. Further history revealed that...

Hypopituitarism secondary to pituitary apoplexy is a rare but recognised complication following cardiac surgery but not cardiac arrest.We present a case report of acute pituitary apoplexy following a cardiac arrest on a background of sepsis. A 65-year-old gentleman presented with 3-day history of abdominal pain and vomiting. Of note, he underwent an appendicectomy 2 months earlier. He was septic and investigations revealed bowel perforation with faecal p...

A 36-year-old male presented to the emergency department with a 24-hour history of mutism, paranoia and 3-day history of social withdrawal. He was unable to engage with healthcare professionals and the history was elicited from his mother. Due to a background of mild depression, an acute psychotic diagnosis was initially pursued. A CT scan on admission revealed a large pituitary lesion. A pituitary MRI scan thereafter demonstrated a large 25 × 30 × 18 mm sellar and s...

Primary hyperparathyroidism (PHPT) is a common condition, affecting approximately 1% of the general population. In women of childbearing age, the correct diagnosis and management is particularly important since PHPT is associated with miscarriage, pre-eclampsia, intrauterine growth restriction, preterm delivery and postpartum neonatal hypocalcaemia. We describe a case series of six women diagnosed with PHPT and their management during pregnancy. In four cases, the PH...