Endocrine Abstracts

A 37 year old male presented with visual problems in June 2006.He gave a history of double vision for 18 months and denied headaches.On examination his Glasgow coma score was 15/15, pupils were equal and reactive to light. Visual acuity; right eye - 6/6, left eye- 6/60. Visual field testing showed a temporal field defect in the right eye and poor vision in the left eye.MRI brain scan showed a very large, fair...

Road traffic accidents resulting in traumatic brain injuries are increasingly common. Patients are often males in their third decade. Many of these patients persist to have various symptoms even after recovery from the acute phase, which tend to be diagnosed as post concussion syndromes. Interest has increased of late in Post traumatic hypopituitarism. We report two patients with head injuries with endocrine insufficiencies.A 21 year male was hit by a ca...

A 57 year old Caucasian woman complained of severe back pain and arthralgia of large joints. Her arthralgia gradually got worse and she also noticed proximal muscle weakness. Blood tests showed normal CRP but elevated alkaline phosphatase of 521 iu/l with normal Gamma GT. Phosphate was low at 0.75 mmol/l with normal corrected calcium of 2.6 mmol/l. A DEXA scan suggested osteoporosis (Spine T −2.5). Isotope bone scan revealed increased activity in the right tibia and plai...

A 68-year-old woman presented with hypertension, oedema, weight gain and moon face. She had signs of proximal muscle weakness, thinning of scalp hair and bruising on her legs. Initial tests showed 24 hour urine free cortisol elevated at 946 nmol (0–300 nmol).Serum cortisol showed no circadian fluctuation (0900: 1094 nmol/l, 2400 hrs: 886 nmol/l) and no suppression by dexamethasone (2 mg/24 h for 48 h: 1067 nmol/l). ACTH levels were slightly raised (...

A 36-year-old male presented to neurologists with tiredness and clumsy gait. Examination revealed normal cranial nerves, spastic paraparesis and bilateral extensor plantar response, absent vibration sense and ataxia. He was thought to have an inherited form of Spino-Cerebellar ataxia. His mother had developed similar neurological problems in her 50 s, and his maternal uncle had Addison’s disease.He was referred to endocrinologists because of the fin...

Pituitary apoplexy is an acute medical emergency but there are no evidence based management guidelines, especially for neurosurgical intervention.A 35-year old male presented with sudden onset severe headache. On examination blood pressure was 180/120 without any lateralising neurological signs. He appeared acromegalic with a short history of enlarging hands & feet. Emergency CT scan and a MR scan later confirmed haemorrhagic pituitary adenoma, 3 cm ...