Endocrine Abstracts

Background: Gynaecomastia results from the raised oestrogen-to-testosterone ratio caused by relative oestrogen excess or testosterone deficiency. Alterations to androgen sensitivity causes a relative testosterone deficiency that can present in a spectrum, from significant, to subtle alterations of secondary sexual characteristics. Mild androgen insensitivity syndrome (MAIS) should be considered in the differential for those presenting with gynaecomastia with elevated gonadotro...

This is a case of 23 year-old male who presented with 2 months history of significant lethargy, erectile dysfunction and lack of libido. He has obesity with BMI of 43, and fatty liver disease. His sense of smell is intact. His random testosterone level was low at 5.8 nmol/l, and repeat 9 am fasting testosterone was 8.4 nmol/l (8.3–13.2), with normal gonadotrophins. SHBG was 15.2 nmol/l (14-71), which is at the lower end of normal. The rest of pituitary profile were unrema...

Kallman’s syndrome is a abroad term which refers to association of olfactory alterations and idiopathic hypogonadotropic hypogonadism and it is responsible for approximately 50% of all cases of idiopathic hypogonadotropic hypogonadism. It is classically associated with KAL1 gene mutation. However, it is not caused by this single gene alone, but multiple genes have been found associated. We present a 31-year-old male Nurse with CHD7 associated Kallman’s syndrome. He w...

A 33 year old male is being follow-up for testosterone replacement (rx) after undergoing bilateral orchidectomy. He was diagnosed with a left testicular germ cell tumor at 20-years of age needing left orchidectomy, followed by a right testicular orchidectomy 2 years later in view of a lump in his right testicle. He did not receive any chemo/radiotherapy. Pre-operative LH, FSH and testosterone levels were normal; 2.4 U/l (0.8–7.6), 3.2 U/l (0.7–11.1) and 16 nmol/l (10...

48-year-old taxi driver presented with a 2-year history of subfertility and confirmed azoospermia. He had normal libido and normal sexual function. His height was 156 cm and he had a normal blood pressure. His medical history included pre-diabetes. He took no regular medications. He had never smoked and he did not drink alcohol. He denied use of exogenous anabolic steroids. His blood tests showed a normal testosterone level of 17.6 nmol/l (RR10.0-3.0 nmol/l) with low gonadatro...

Gonadotropin-releasing hormone (GnRH) antagonists, primarily used in prostate cancer treatment, have found application in androgen-secreting ovarian tumors. Among these, degarelix, a pure GnRH antagonist was found to rapidly suppress testosterone levels within 24 h. Testosterone fell from 14 nM to 1.5 nM within 24 h and to less than 1 nM within 48 h. A 77-year-old woman presented with hirsutism and voice deepening over the past few months. Elevated serum testosterone levels wi...

Introduction: Gynecomastia is a condition characterised by the benign proliferation of breast tissue growth in males. Among variety of causes, 3% of cases are due to testicular tumours. [1]. We present a 35-year-old male, who had elevated estradiol levels and gynecomastia, who was found to have a Leydig cell tumour. Case Presentation: A 35-year-old male was referred to our clinic with 3 month history of bilateral breast growth. He had no significant medi...

Diagnoses: Primary hypogonadism, GynaecomastiaCase: A 36 year old male presented with bilateral gynaecomastia via his GP. He otherwise felt well in himself and was not significantly affected by this condition. He had initial workup investigations then was lost to follow up and results until 2 years later in my clinic. On review he reported a normal for him libido, normal erections, normal ejaculation. He reported no issues with energy levels, he works in...

Menopause may cause a constellation of symptoms associated with reduced quality of life. Loss of libido is a common one, although there still is uncertainty about its management in clinical practice. This 50-year-old lady was seen in the endocrine clinic complaining about fatigue and loss of libido. The patient’s journey started 3 years earlier when she was commenced on hormone replacement therapy (HRT) in the community. After a short treatment with Evorel Sequi, as libid...

A 33-year-old rehabilitated intravenous drug abuser was referred in view of bilateral gynaecomastia. The gynaecomastia developed gradually over a year with the left breast greater than right, and associated with intermittent tenderness but no galactorrhoea. He was found to have a low total testosterone and elevated oestradiol level. The patient claimed to have had undergone normal puberty with normal secondary sexual characteristics. He was able to maintain a beard, and had no...

Case 1: A 33-year-old male patient with seven years of erectile dysfunction and aspermia presented for a fertility opinion. He had a diagnostic of macroprolactinoma a year ago when Cabergoline was started with a gradual increase of the dose. Upon his initial evaluation in our clinic, on 2 mg Cabergoline weekly, his serum PRL level was × 10 UNL, decreased 70% from the diagnostic, and the tumour shrinkage was 60% from the diagnostic. A gradual increase of the Cabergoline up...

30 year female diagnosed with AML at the age of 3. On diagnosis in 1996 had recurrence of AML 1998 had Bone marrow transplant with Total body irradiation and cyclophosphamide preconditioning 1998. She had suffered with post transplant cardiomyopathy (1999) Primary ovarian insufficiency and Childhood growth hormone replacement therapy (discontinued 2010) and recently found to have possible post irradiation induced Hypercalcaemia. She weighs 40 kg, height 4 ft 11 inches and BMI ...

Background: Turner syndrome (TS) affects around 1:2000 women and is the most common genetic cause of primary ovarian failure (POF). These patients require timely sex steroid replacement and are at increased risk of osteoporosis.Clinical case: A 34-year-old female diagnosed with TS aged 10 years, attended the endocrine clinic after her care was transferred from Ukraine. She received growth hormone treatment for 4 years from the age of 12 and was commenced...

A 66-year-old female patient presented post-menopausal with vaginal bleeding. She was on Oestrogen cream. The US showed a right ovarian cyst. The C125 was normal, and the uterine biopsy showed no malignancy. The bleeding continued and she was reviewed 4 months later. The MRI shows evidence of uterine adenomyosis. The right ovarian cyst is likely to represent a right ovarian endometrioma (32 × 28 × 30 mm). She was referred to the endocrine clinic for as increased hair...