Endocrine Abstracts

I would like to present the case of a 66-year-old gentleman with McCune–Albright syndrome. This unusual condition consists of three main features; namely, polyostotic fibrous dysplasia, café au lait patches on the skin and hormonal abnormalities, including acromegaly.

The presentation will look briefly at these three elements and the investigations leading up to diagnosis. However, the main focus will be on the psychological impact illness has had on this patient and his slow recovery from debilitating depression.

Investigations into this patient’s condition began only when he was admitted to hospital with a suspected pulmonary embolus. At that time, a sharp-eyed health professional in the Accident and Emergency Department noticed that his features were acromegalic; a term hitherto unknown to the patient.

For several months prior to this, the patient had been experiencing a gradual lowering of his mood, together with an increasingly overwhelming exhaustion. As he explained, he managed to continue to work, but was so tired he could do absolutely nothing else. His fatigue was so extreme, that some nights he was too weary to get up from his armchair to go to bed.

This poor quality of life led to unhealthy coping mechanisms, such as comfort eating. The inevitable weight gain further reduced his capacity for exercise and the inexorable downward spiral in both physical and mental well-being began.

With regular support from both the endocrine consultant and specialist nurse the patient eventually reached a turning point. He began to lose weight, ultimately losing 30% of his body weight, became a volunteer at the hospital and started to rebuild a social life. Since then, he has blossomed and his self-esteem restored.

In the light of this, I will look at the role of the endocrine nurse in the ongoing treatment and monitoring of this condition and discuss the importance of holistic care of patients with lifelong endocrine conditions.