Endocrine Abstracts

Clinical case: A 37 year-old Caucasian man was admitted with sudden onset lower limb weakness following a carbohydrate-heavy meal the night before. Pulse was 110/min, sinus rhythm, BP 167/92 mmHg. There was generalised muscle weakness, particularly in his legs, with hyporeflexia and hypotonia. There was no sensory deficit and plantar responses were downgoing. Serum K+ was 2.4 mmol/L, associated with typical ECG anomalies, and was corrected with 40 mmol intravenous KCl followed...

Background: The purpose of this study was to measure the ability of Microvascular ultrasonography (MVUS), which is a third-generation Doppler technique developed to increase sensitivity, to distinguish Graves’ disease (GD) from destructive thyroiditis (DT).Methods: This prospective study included a total of 167 patients from October 2020 to January 2023. Of them, 85 were patient with GD. All ultrasonography examinations were performed using microvas...

The diagnosis of Pheochromocytomas often poses a great challenge. We report a case of pseudo-pheochromocytoma causing challenges in the clinical diagnosis. A 35-year old gentleman with high BMI, was admitted with worsening headache, visual field defects and accelerated hypertension. MRI pituitary and biochemical profiling revealed a non-functioning pituitary macroadenoma with optic chiasm compression, warranting urgent surgical intervention, vindicating an endocrinology referr...

Objective: To evaluate the efficacy of medical management of hyperparathyroidism and evaluate the financial and healthcare impact of delay in surgical intervention within a district general hospital. To assess the duration of use of cinacalcet prescriptions, compare wait times for surgery and assess the service needs.Method: We retrospectively evaluated all patients with primary hyperparathyroidism who received cinacalce...

Non-diabetic euglycaemic ketoacidosis (NDEK) is a rare condition defined as euglycaemia, metabolic acidosis and elevated serum ketones occurring in patients without diabetes mellitus. It is less well known compared to diabetic ketoacidosis (DKA) and euglycaemic diabetic ketoacidosis (EDKA), both happening in patients with diabetes. Here we describe a case of a 35-year old woman, previously fit and well, who presented with unidentified cause of pancreatitis leading to severe me...

Hyponatraemia in pregnancy can be precipitated by various factors, including drugs, fluid excess and oxytocin infusion. It is a common complication of pre-eclampsia toxaemia (PET), although concomitant syndrome of inappropriate ADH secretion (SIADH) in this context is rare. We present a case of SIADH leading to hyponatraemia in a PET patient. A 30 year-old primigravid woman with bipolar disorder and hypertension was admitted with pre-eclampsia at gestational week 28. Her medic...

Introduction: In cases of emergent surgical conditions, pre-medication of patients with thyrotoxicosis is required to reduce the patient’s risk of thyroid storm in the perioperative and postoperative state. Perforated viscus with concurrent thyrotoxicosis is rarely reported. We report 2 cases of thyrotoxicosis and acute abdomen with perforated viscus.Case 1: A 27-year-old gentleman with underlying hyperthyroidism, presented with central epigastric p...

Parathyroid hormone is a polypeptide consisting of 84 amino acids. Quantification of circulating intact PTH assists in the differential diagnosis of hypercalcemia. It is important to interpret PTH results with caution and to keep in mind Immunoassays interference can also be a reason of falsely high PTH levels. We present an interesting case referred with high parathyroid hormone levels. A 74 years old female attended clinic with raised PTH levels of 11.7 pmol/l, a normal calc...

A 55 year-old Nepalese lady, previously fit and well, presented to her GP 2 months ago with palpitations and weight loss. She was diagnosed with Graves thyrotoxicosis based on her clinical history and biochemistry, and was started on carbimazole 40 mg daily. She suffered from COVID19 infection a month later and started self-isolating. She continued to feel unwell for three weeks but did not seek urgent medical attention due to the perceived general recommended isolation guidel...

The neonatal immune system is not fully developed, making neonates more susceptible to early-life infection. Early-life activation of the immune system has lasting implications for health and disease. Glucocorticoids (GCs) are steroid hormones that modulate the immune response and increase in response to immune activation. GCs are produced by the adrenal glands and also by lymphoid organs (e.g., bone marrow, thymus, spleen). In neonatal mice, GC levels increase acutely in bloo...