Endocrine Abstracts

We present the case of an 18-year-old undergraduate student who originally presented to his GP in July 2005 with weight loss and lethargy. He was given a tentative diagnosis of ‘honeymoon’ phase Diabetes Mellitus Type 1. However, further tests ruled out Diabetes. At the end of 2005, he was referred to our Diabetologists with further concerns about weight loss, and a reported brief episode of loss of consciousness while vigorously cycling. When seen by the Diabetes colleagues, he described night sweats, tiredness, polyuria, feeling cold, symptoms resembling hypoglycaemia, loss of 4 stone in weight in 9–12 months and occasional diarrhoea. He reported that he was a fanatical excerciser on his bike and was exercising himself to near destruction. Pituitary function tests showed low testosterone and gonadotrophins, raised levels of 9.00 am cortisol and marginally raised TSH.

Subsequently, he was referred to our Endocrine Team, where further investigations were arranged for the above hormonal findings. With regards to the polyuria and the possible presence of Diabetes Insipidus, he underwent a Miller and Moses water deprivation test.

All the diagnostic steps undertaken, their results and the final conclusions we came to are discussed.