Endocrine Abstracts

Case: A 73 year old man was seen in eye clinic with 5 month history of visual problems. He was diagnosed with bilateral glaucoma and early Cataracts. His vision was not improving despite eye drops and new glasses thus cranial imaging was requested. He also complained of feeling off balance and tiredness. He denied headache or galactorrhoea. Examination: Bitemporal hemianopia (L>R). Investigations: CT head scan – Pituitary Macroadenoma 3.6×3.1×3.8 cm, with di...

31 year old lady was referred to the endocrine clinic by her GP in August 2008. She had 1 year history of galactorrhoea, 4 months history of irregular periods and intermittent short lived severe headache in the right temporal area without visual disturbance. Her investigation showed a prolactin level of 900 mmol/l, subsequent MRI scan confirmed the presence of right-sided pituitary adenoma of around 1 cm in size with evidence of recent haemorrhage in to it and normal other pit...

A 36 year old lady presented to the endocrine clinic with a 4 month history of secondary infertility, amenorrhea, galactorrhoea and headaches. She had stopped breast-feeding her 5th child 18 months previously and was not taking any antidopaminergic drugs. She had a normal neuro-ophthalmic examination, including full visual fields to confrontation with a red pin. Her prolactin was elevated at 5690 mU/l and MRI pituitary confirmed a 17 mm partially cystic macroadenoma which was ...

Case history: A 39 year old lady was referred to the endocrinology clinic with difficulty conceiving, after screening bloods revealed an elevated prolactin (1816 miu/l)). There was no past medical history or family history of note and she took no regular medications. She denied headache, visual disturbance or galactorrhoea. Systemic examination was normal.Investigations: Elevated prolactin was confirmed on a cannulated sample (1435 miu/l). Further analys...

A 34 year old male, previously healthy nightclub doorman presented with 2 years of reduced libido, fatigue, hot flushes and reduced beard growth. He had fathered three healthy children. He admitted to previous use of veterinary anabolic steroids up until 2 years ago. He had normal secondary sexual characteristics, no features of pituitary hypersecretion, normal visual fields but reduced testicular volumes (8 ml).Biochemical investigation showed growth ho...

Case history: A 19 year old lady presented with amenorrhoea, fatigue and headaches. She had normal pubertal growth spurt with an appropriate height for mid-parental height. Her menarche was at age 17, another bleed at 18 but amenorrhoeic since. There was right sided galactorrhoea only on expression. In her teens she had an eating disorder, periods of self-harm and low mood. No treatment except for St. John’s Wort occasionally. No visual disturbance was present.<p clas...

A 48-year-old gentleman was admitted to AMU overnight in January’12 from eye casualty with weeks of worsening visual disturbances followed by rapid deterioration – complete loss of vision in the right eye and a temporal hemianopia on the left side but no headache.Urgent hormone profile revealed elevated prolactin 53 988 mU/l, low testosterone of 3.3, SHBG 22, LH 2, FSH 3.1, IGF1 292, satisfactory SST (0 min cortisol 213 with ACTH 10 and 30 min ...

A 50 year old male presented with left visual field loss, afferent pupillary defect and reduced libido in 1999. Initial pituitary profile showed prolactin 130 000 mu/l (55.4–276), and testosterone was 5 nmol/l (10–27.6). MRI pituitary showed giant pituitary macroadenoma compressing chiasm. He was started on Cabergoline with subsequent improvement in visual fields, prolactin levels and size of adenoma on subsequent MRI. His disease remained stable on ...