Endocrine Abstracts

A 37-year-old female was referred with recurrent episodes of altered consciousness and disorientation. She described a three-year history of recurrent “funny turns”. They started with a sensation of warmth accompanied with cold sweat followed by unfamiliarity with the surroundings and cognitive impairment. The attacks increased in frequency gradually over time. There was a tendency for the attacks to occur in the morning, before bed and 3–4 hours after food. The...

We report a 49 year-old female patient who was referred to the endocrine clinic with two months history of heat intolerance and weight loss. She denied any symptoms related to her eyes. Past medical history included hypertension, epilepsy and manic-depressive psychosis, and she was on lithium, atenolol, phenobarbitone, doxazosin and phenytoin. On examination, there was a 45 g firm symmetrical multi-nodular goitre (MNG) with normal examination of both eyes. Thyroid function tes...

Introduction: Evaluation and management of thirst and polyuric syndromes can be challenging in endocrine practice.Case report: A 24-year old lady presented with weight loss, thirst, polyuria, vomiting and abdominal pain. She had acromegaly treated by transsphenoidal surgery 5 years ago. Medications included hydrocortisone, thyroxine (T4), the oral contraceptive pill as well as bromocriptine for postoperative acromegaly. Examination revealed postural hyp...

Introduction and aims: The role of screening for thyroid disease in diabetes (DM) remains controversial. We assessed the prevalence of thyroid dysfunction on first screening in a population of patients with diabetes who previously had thyroid function tests (TFT) only on clinical suspicion.Methods: TFT and thyroid peroxidase antibodies (TPO) were measured in 236 consecutive patients with DM (mean age 59±13 years, type1 16%, type2 84%, female 48%)...

Patients with diabetes are prone to peripheral vascular disease. We present the case of an 81 year old female, current smoker who presented to her general practitioner with a 3 day history of ankle oedema for which she received furosemide. She had a background of right above knee amputation due to peripheral vascular disease and essential thrombocythaemia. Five days after commencing furosemide, she developed increased lethargy and confusion. On arrival to hospital, her venous ...

This 23 years old man was noted incidentally to have bilateral adrenal calcification on CT scan of his abdomen for chronic abdominal pain. He had normal growth and milestones with no neonatal events. Aged 10 years he was admitted briefly to a high dependency unit with circulatory shock and hyperthermia, with isolation of Streptococcus mitis from blood culture. One year later he was noted to have bilateral adrenal calcification on abdominal XR, and a short Synacthen (250 μ...

Background: Letrozole is a potent aromatase inhibitor licensed for use in women with breast cancer. It is also used by body builders for reduction of gynecomastia when taking anabolic steroids. Supply for this unlicensed use is readily available through internet. Testosterone production is regulated by negative feedback of estrogen on the pituitary. The use of letrozole can therefore cause supraphysiological levels of testosterone in men. We present such a case.<p class="a...

Background: Primary Hyperparathyroidism is mainly produced by an adenoma and it is mostly a benign condition. Most of the patients are asymptomatic. We present a case of ectopic parathyroid cyst presenting with this condition.Case: A 76 yr female presented with new onset confusion, abdominal pain, vomiting, diarrhoea and dehydration. She was currently being treated for a urinary tract infection. Investigations showed acute kidney injury with creatinine 3...

Objectives: Increasing use of scanning has led to a significant increase in detection of adrenal incidentalomas. The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons have issued guidelines for evaluation of adrenal incidentalomas in 2009. We audited our current practice at Royal Shrewsbury Hospital against the 2009 guidelines.Method: Retrospective audit of patients found to have adrenal masses on imaging st...

Background: Primary hypoadrenalism with bilateral adrenal enlargement is a relatively rare condition. We present four such patients. Case 1: 60 year old male presented with malaise, weight loss and hyponatremia. Short synacthen test was abnormal and ACTH was raised (309 ng/L). CT adrenals showed bilateral adrenal enlargement with uniform texture and low attenuation with no change in repeat CT. FNAC of adrenal gland showed infarcts. Further tests confirmed antiphospholipid anti...