Case presentation A 64-year-old male patient presented at an Endocrine clinic with a long-standing history of 18 years of erectile dysfunction and loss of libido. Under urology, he was treated for hypogonadism with phosphodiesterase inhibitors and Nebido injections. The cause of hypogonadism was not established.
For the 5-year history of xerostomia, he was assessed by a dermatologist for a non-healing erythematous, pruritic lesion on the right lower leg and white and pink polycyclic patches over the left upper arm. For supposed primary hypothyroidism , he had been treated with levothyroxine for ten years. Investigations Morning serum testosterone: 4.9 nmol/l (reference range 80-30.0) Gonadotrophin and SHBG: Not tested Testosterone: 8 nmol/l LH: <0.3 IU/l FSH: <0.3 IU/l SHBG: 42 nmol/l Anterior pituitary hormone profile: IGF-1: 3.9 nmol/l (reference range 10.1-28.4) Morning…
