Endocrine Abstracts

A 45-year-old man who works as a psychotherapist was referred with an incidental finding of a rudimentary uterus and bilateral pelvic gonads on pelvic computerized tomogram and magnetic resonance imaging. This was performed for investigation of abdominal pain which has since settled. As far as he is aware he was born without complications and developed normally through childhood. He progressed through puberty uneventfully with voice changes by 13 years and shaving by 16 years....

A 37 year old gentleman with no significant past medical history presented with 2 day history of acute onset headache, nausea, vomiting, photophobia and fever. He was pyrexial. He had no focal neurological deficit but marked neck stiffness. His inflammatory markers were raised. CT head showed large pituitary tumour. He was started on Dexamethasone and IV Ceftriaxone and transferred to tertiary centre. MRI brain showed large pituitary macroadenoma projecting into right cavernou...

Over recent years, the numbers of commercially available slimming aids have increased dramatically. Whilst the majority of these aids are harmless, their interaction with normal physiology is either not understood or not brought to the attention of the customer. We report the case of a 45-year-old woman who presented with clinical and biochemical thyrotoxicosis (fT4 31.5 pmol/l, fT3 14.3 pmol/l, TSH <0.02 mIU/l). She had elevated TPO antibodies (51 IU...

Thyroid storm or thyrotoxic crisis is a manifestation of an extreme state of thyrotoxicosis. It is both rare and potentially fatal. Its presentation can be clouded by the precipitating illness and the involvement of one or more organ systems underlining the importance of clinical suspicion, early recognition and prompt intervention.We present a case of a 37-year-old man presenting to hospital with a community acquired chest infection that had not settled...

This 52-year-old lady presented in 2001 at a GI clinic complaining of occasional abdominal cramps, which could be severe and prolonged. Her symptoms were not associated with diarrhoea or constipation. Weight loss of 4.5 kg over 4 months was noted. Coeliac disease was excluded and a diagnosis of severe irritable bowel was made.In January 2002 she returned to the clinic with further weight loss (total 8 kg), cyclical symptoms of diarrhoea lasting 3–5 ...

A 37-year-old Caucasian man was referred for assessment of borderline hypocalcaemia (2.15 mmol/l) associated with hypophosphataemia (0.32 mmol/l) and elevated serum PTH (145 ng/l). Serum 25OH cholecalciferol was normal (39 mmol/l). Some weeks earlier he had been admitted to hospital as an emergency with severe, colicky right sided abdominal pain. The pain had settled spontaneously and no cause was found. He had subsequently suffered isolated attacks of strangury, dysuria and t...

Cinacalcet, a calcimimetic, is licensed for the management of primary hyperparathyroidism (PHP) where surgery is deemed inappropriate. It is unclear when patients might be deemed more appropriately managed by medical treatment rather than surgery. We report two cases in which cinacalcet has been used to predict the effect of parathyroidectomy and a choice to be made between surgery and conservative management.A 43-year-old woman had a parathyroid adenoma...

Hyperthyroidism per se can cause mild elevation in liver enzymes which normalizes with treatment. Thyrostatic medications (carbimazole or propylthiouracil) as first line therapy to treat hyperthyroidism can rarely cause potentially fatal hepatotoxicity.We report a patient who developed cholestatic jaundice after carbimazole therapy.Case report: A 32-year-old woman presented with weight loss, heat intolerance, palpitations an...

Background: Thyrotoxicosis can be associated with various psychiatric symptoms, such as emotional lability, anxiety, restlessness and rarely frank psychosis. We report such a case.Case report: Forty-seven year old female presented with palpitations, agitation, irritability, itching of her eyes in March 2007. She denied history of tremor or insomnia. No history of drug or alcohol abuse. No personal or family history of depression or any other psychiatric ...

Case report: A 33-year-old pregnant Nigerian woman presented at 37 wks gestation with a 2-week history of frequent headaches and visual disturbance. She had persistent galactorrhoea following previous pregnancy in 1998, which settled after a short course of bromocriptine. On examination, she had classical bitemporal hemianopia. Her prolactin was raised at 19,220 mU/L (higher than expected in a normal pregnancy), random cortisol 553 nmol/L and thyroid function tests satisfactor...