Endocrine Abstracts

A 70-year-old woman presented with low back pain. A diagnosis of discitis (L4-L5) was made and the patient was started on IV flucloxacillin 1 g every 6 h and fusidic acid. The back pain was improving and the serum electrolytes were all within normal range with potassium level at 4.4 mmol/l (normal: 4.0–5.5) and magnesium at 0.68 mmol/l (normal: 0.7–1.1). However two weeks after starting the IV flucloxacillin, the patient’s electrolytes showed a persistent hypoka...

Introduction: Hirsutism, the presence of terminal (coarse) hairs that appear in a male-like pattern, affects 5–10% of women and may cause concern for an underlying endocrine disorder or malignancy. Spironolactone compete for the androgen receptor in the hair follicle, therefore, it is frequently used in treatment of hirsutism. We report a case, in which treatment of hirsutism with Spironolactone interfered with androstenedione immunoassay and raised unnecessary concern ab...

A 71-year-old man with carcinoma of prostate and bony metastasis, presented with acute bradyarrhythmia, severe hypocalcaemia and acute renal failure 72 h after intravenous infusion of zoledronate. Before therapy, serum calcium was 2.14 mmol/l (normal, 2.10–2.55 mmol/l), serum phosphate 1.4 mmol/l (normal, 0.8–1.5 mmol/l), serum creatinine 95 umol/l and eGFR 74 ml/min. 25OH vitamin D was not measured. Three days later he presented with a syncopal episode. Initial bloo...

We describe two cases of sarcoidosis associated hypercalcaemia, renal failure and anaemia mimicking lymphoma. The diagnosis was made by lymph node biopsy. Within weeks of starting oral steroids, symptoms resolved and biochemical abnormalities almost normalized.Case 1: A 66-year-old lady, presented with generalized weakness, lymphadenopathy and splenomegaly. Hb 96 g/l, MCV 91, urea 16.6 mmol/l, creatinine 227 umol/l, eGFR 15 ml/min, serum calcium 3.4 mmol...

Introduction: Adrenaleukodystrophy is an X linked disorder associated with functional defect of very long fatty acid (VLFCA) oxidation leading to accumulation of VLFCA in the white matter of brain and adrenal cortex. It usually presents with adrenal insufficiency and neurological problems and has association with other autoimmune conditions reported so far including vitiligo, ulcerative colitis. We report a case of adrenaleukodystrophy, vitiligo and hypothyroidism.<p class...

We describe an 80 year-old man with Graves’ thyrotoxicosis and thyroid orbitoapthy accompanied by ocular myasthenia gravis.He presented in 2004 with chemosis, exophthalmos, diplopia, ptosis, and restricted movements. He also gave history of weight loss (six kilograms). FT4 29, FT3 7.7 and TSH 0.04. MRI Orbits revealed swelling of the extra-ocular muscles.Ocular movement was markedly restricted but a curious feature of the pres...

Introduction: Primary hyperparathyroidism is not an uncommon disease with incidence of ~25–30 cases per 100 000 people, whether caused by adenoma or hyperplasia, can be cured surgically with a high rate of success. Over past decade minimally invasive surgery has become mainstay of treatment compared to traditional bilateral exploration approach. Accurate preoperative localisation of parathyroid disease is absolutely imperative for effective minimally invasive surgery....