Endocrine Abstracts

Case history: A 25-year-old woman presented with secondary amenorrhoea present since aged 18yrs. She had spontaneous albeit late menarche aged 16yrs and five menstrual periods over the subsequent two-years, before complete menstrual cessation. She denied other medical history, psychological stress, excessive exercise, or regular medications. Notably, she reported normal sense of smell via her right nostril, but anosmia via her left nostril. Family history included a diagnosis ...

Case History: A 26-year-old woman with known metastatic adrenocortical carcinoma (ACC) was transferred to our department with recurrent severe hypoglycaemic episodes. Her ACC was diagnosed in 2018 and a 175 × 130 × 89 mm 1200 g mass was surgically resected (ENS@T stage-II, Weiss score-5, Ki-67 20%, Helsinki score-28). Her disease progressed despite adjuvant radiotherapy, mitotane and three chemotherapy regimens. In January 2023, she began experiencing episodes of pro...

Case History: A 53-year-old female with MEN2A (C634P mutation) and localised medullary thyroid cancer (MTC) was noted to have an adrenal nodule that was presumed by referring centre to be a phaeochromocytoma, given symptoms of anxiety and palpitations. There were also concerns about possible Cushing’s syndrome, as she reported fatigued, weight gain and a recent diagnosis of type 2 diabetes mellitus. Furthermore, she suffered a tibial plateau fracture which had been manage...

Section 1: Case history : A 20-year-old Bangladeshi female presented to her GP with an 18-month history of nonspecific abdominal pain. She is nulligravida, not sexually active and reports no intermenstrual bleeding, dysmenorrhoea, menorrhagia or dysuria. Past medical history includes obesity, OSA and anosmia. Section 2: Investigations : The patient underwent a TVUS which demonstrated a large (158 × 84 × 156 mm) multiloculated lesion with a soli...

Background: Monogenic familial Partial Lipodystrophy, a rare but clinically important cause of severe insulin resistance, is often underdiagnosed.Case: A 33 years’ lady was referred to the diabetes clinic for sub-optimal glycaemic control. She was diagnosed with diabetes at 22 years of age, insidious in onset, and was managed as Type 2 diabetes for 10 years until presentation. She had a h/o oligomenorrhoea and was diagnosed with PCOS. She also had h...

A-49-year-old female with previous history of Olfactory neuroblastoma treated surgically in 2003 and no adjuvant treatment was given. She has a past medical history of depression, bilateral sensory neural hearing loss which is thought to be genetic. In Feb 2023 presented with uncontrol hypertension associated with hypokalaemia. Clinical examination showed BMI of 48.4, uncontrol high blood pressure despite using multiple antihypertensive medication. The initial assessment for t...

Case history: This 27 year female was first seen at GSTT in 2012, having had treatment for acromegaly due to a presumed GH-secreting adenoma in 2007 (Trans-sphenoidal surgery × 2, EBRT (2007), pegvisomant (2007-2012 (discontinued due to adverse effects)), & GammaKnife SRS (2011). GH and IGF-1 remained elevated and further treatment with pegvisomant/ SSA was declined. Abnormal bone growth with jaw and skull asymmetry was evident from age 10 years and final height was 1...

Case History: A 57-year-old lady was referred with a 6-year history of hypertension and hypokalaemia necessitating hospital admission. Her medical background included breast cancer managed with chemotherapy, radiotherapy and surgery. She required Eplerenone 50 mg OD and Amlodipine 5 mg to control her hypertension, and Sando-K 2 tablets TDS to maintain normokalaemia. The patient was enrolled into the MATCH trial comparing adrenal vein sampling (AVS) with [11C]-metomi...

A 26-year-old primigravida woman presented with hypercalcaemia at 8-weeks gestation. Initial symptoms included nausea, vomiting and palpitations, with an admission serum adjusted calcium of 3.8 mmol/l. A biochemical diagnosis of primary hyperparathyroidism (PHPT) was supported by a raised PTH and a 24-hour urinary calcium-creatinine ratio of 2.0 mmol/ mmol, excluding familial hypocalciuric hypercalcaemia. Initial management with intravenous fluids and antiemetics was unable to...

Clinical Case: A 30-year-old female was referred with subfertility and hypogonadotropic hypogonadism. She had systemic lupus erythematosus (SLE) and was on maintenance 5 mg prednisolone, having received intermittent high doses since her diagnosis in 2018. She reported 12 months of amenorrhea and reduced libido without galactorrhoea, despite regular menses since menarche aged13. This coincided with a rapid weight gain of 20 kg. On examination, her BMI was 36.8 kg/m2,...