Endocrine Abstracts

We report two cases of severe hypocalcaemia developed after intravenous administration of pamidronate in patients with severe hypercalcaemia secondary to multiple myeloma. Both of them develop symptomatic hypocalcaemia few days after treatment. Both patients was probably vitamin D deficient (both serum 25-hydroxyvitamin D level was low less than 15 (NR 25–120 nmol/l) because of a combination of poor oral intake, inadequate sunlight exposure, and the development of renal f...

Increasing use of abdominal imaging has led to an increased detection of incidental adrenal masses. These cases are usually referred to the endocrinologist for further investigations. We present two cases with unusual incidentalomas. Case 1: a 63-year old man presented with acute abdominal pain. He was haemodynamically stable and afebrile. Investigations revealed normal biochemistry, amylase and clotting. White cell count raised, haemoglobin and platelets normal. Chest ...

Objective: To determine prevalence of pre-diabetes and diabetes mellitus in polycystic ovarian syndrome (PCOS).Study Design: Cross sectional study. Non probability consecutive sampling was done.Sample Size: The estimated sample size was 84 women with 95% confidence level and confidence limit of ±5%.Setting: Outpatient departments of Medicine and Gynaecology & Obstetrics at a tertiary care hospital of...

Background: Conventional management for thyrotoxicosis includes anti-thyroid medications, radioactive iodine and/or surgery. However, in some cases patients are resistant to first line drugs and need second line treatment to normalize thyroid function tests (TFTs) before considering definitive therapy. We present a case of Grave’s disease where patient didn’t respond to first line anti-thyroid medications and required Lithium and Cholestyramine to achieve euthyroid s...

We present the case of a 50-year-old woman who presented with 12 months of amenorrhea associated with signs of virilisation. Investigations revealed markedly raised serum concentrations of testosterone (9 nmol/l), whereas sex hormone binding globulin, random cortisol, androstenedione, 17-hydroxyprogesterone and dehydroepiandrosterone sulphate concentrations were all within the normal range. Computed tomography scan of the pelvis and abdomen showed a slightly bulky right ovary,...

Background: Resistance to thyroid hormone (RTH) is a rare autosomal dominant condition of altered tissue responsiveness to thyroid hormone (TH) characterised by elevated serum FT4 and FT3 and non-suppressed TSH levels caused by mutation in the thyroid receptor (TR) β gene. Different isoforms of TR are expressed in the heart and regulate genes that encode structural and regulatory proteins. The syndrome is characterised by a variable clinical phenotyp...

Introduction: It is known that certain endocrine disorders are related to each other and occur together due to their autoimmune aetiology. Patients with an autoimmune disease must be considered at risk for other autoimmune disease. Addison’s disease usually presents with recurrent hypoglycaemia in subjects with type 1 diabetes mellitus.We present a case Addison’s disease in type 1 diabetes presenting with severe hyperglycaemia.<p class="abs...

Introduction: Cushing’s syndrome is characterised by glucocorticoid excess. This is more commonly caused by excess adrenocorticotropic hormone (ACTH) produced either by a pituitary tumour (Cushing’s disease) or ectopic secretion. An example of the latter is the production of ACTH by a lung carcinoma (typically small cell)1. Other causes of Cushing’s syndrome include long term steroids or adrenal carcinoma.Case history: A 62-year...

Introduction: Thyroid eye disease affects an estimated 400,000 people in the UK and for a sizeable minority this is an extremely unpleasant condition. Radioactive iodine treatment with I131 for thyrotoxicosis can cause sight-threatening flare-up of dysthyroid eye disease. Patients with dysthyroid eye signs should undergo specialist ophthalmology assessment prior to administration of I131.Case history: A 56 year old gentleman presented with symptoms of th...

Background: Vitamin D supplements are readily available without prescription. Although vitamin D toxicity is infrequent, rising use may lead to an increase in reported cases. We present a case of hypercalcemia and acute kidney injury due to excess vitamin D intakeCase: A 46-year-old woman was admitted with three-month history of lethargy, reduced oral intake, and constipation. She also experienced intermittent nausea and...