Endocrine Abstracts

We describe a 82 year old patient with background history of thyrotoxicosis (had total thyroidectomy), primary hyperparathyroidism (had parathyroidectomy 12 years back at another hospital – two glands removed). She was on L-thyroxine, alfacalcidiol 1 μg/day and CaCO3 500 mg BD. She remained stable for 7 years on this cocktail. In February 2017, she was admitted with acute confusion and was found to have adjusted ca level of 4.57 with AKI, no...

A 27 year old, Caucasian female was admitted with vomiting and found to have severe hypocalcaemia. On clinical examination she had a normal stature, oval face; she was not brachydactylic and did not have dental hypoplasia. Biochemically she had serum Ca of 1.49 mmol/l (2.15–2.50), a high serum Phosphate of 1.50 mmol/l (0.9–1.45) and Vitamin D levels of 59 nmol/l (>50 sufficient for majority population). Her serum parathyroid hormone was elevated at 304.5 ng/l (15...

A 23 yr old lady was admitted with a generalized tonic clonic seizure in May 2016. Her corrected calcium was 1.47 mmol/l (2.05–2.6 mmol/l) She was initially treated with intravenous calcium gluconate and subsequently switched to oral calcium carbonate tablets and one alphacalcidol tablets once her calcium improved. The patient gave a history of a prior seizure in 2013. At this point she was not investigated for any electrolyte imbalances. She was initially treated with th...

A 36 year old female patient presented to the emergency department with a generalised tonic-clonic seizure. She had a past medical history of epilepsy and tuberous sclerosis. Her medication prior to hospital admission was Tegretol which had controlled her seizures well for many years. On admission, the adjusted calcium level was 1.4 mmol/l with a raised ALP 508 U/l and a phosphate within the normal reference range at 1.1 mmol/l. Magnesium was also within the normal reference r...

Hypocalcaemia is one of the common metabolic abnormalities found in hospitalised patients. The most common cause of hypocalcaemia is Vitamin D deficiency. Others causes include hypoparathyroidism, chronic kidney disease and hypomagnesemia. Multiple factors can co-exist in the same patient. We present here a case of hypocalcaemia caused by multiple factors in the same patient. The patient we present probably had multiple factors contributing to hypocalcaemia. Our hypothesis is ...