Endocrine Abstracts

A 73-year-old gentleman known to suffer from hypothyroidism was admitted to hospital with severe symptomatic hyponatraemia of 112 mmol/l. He was acutely confused with a GCS of 12/15. He was found to be in urinary retention with 650 ml residual urine post catheterisation. Initially, his serum sodium concentration improved on catheterisation and fluid restriction. The syndrome of inappropriate ADH secretion in the context of urine retention was initially suspected on the bases o...

A 40 year old lady known to have type 1 diabetes on insulin pump therapy presented with hypertension at 33 weeks gestation. Treatment with labetalol 100 mg bd was initiated but she was admitted at 34 weeks due to lack of BP control. Sodium levels were 136 mmol/l (135–145 mmol/l) on admission. Labetalol was increased to 300 mg tds and she was discharged after 4 days with a sodium level of 129 mmol/l. She was readmitted at 35 weeks with pre-eclampsia as evidenced by severe ...

A 60-year-old lady with known Rheumatoid arthritis, Ulcerative colitis and hypothyroidism was admitted with a 10-day history of diarrhoea and vomiting in June 2017. Sodium on admission was 107. Sodium rapidly improved with intravenous (IV) saline. She had 3 further admissions in quick succession in July and August. She always had a quick response to IV saline, but sodium dropped once IV Saline was withdrawn. She was started on oral sodium replacement but this had no effect on ...

Background: Hypertension affects 28.6% of adults in the United States. In most, hypertension is primary (essential or idiopathic), but a subgroup of approximately 15% has secondary hypertension. In young adults (<40 years old), the prevalence of secondary hypertension is approximately 30%. Endocrine disorders remain one of the leading causes of secondary hypertension. Primary aldosteronism (Conn’s syndrome), Once thought to be a rare condition and not worth investigat...

History: 80 years old male was admitted in June 2016 with a head injury. His CT head showed small subarachnoid haemorrhage and shallow frontal subdural hematoma. He was managed conservatively as per advice from neurosurgical department and was discharged on 4th July. He was readmitted on 9th July suffering from confusion and found to have sodium of 114 which was 141 a week ago.Investigation: Investigations carried out to find the ca...

We report the case of a 65 year old lady who was admitted to A&E with neurological symptoms (slurred speech, ataxia, intermittent confusion) and she was found to have low sodium (116 mmol/l). She reported 2–3 week history of lethargy and lightheadedness. There was no history of shortness of breath, cough, haemoptysis, weight loss, night sweats, altered bowel habits or excessive fluid intake. Her past medical history included hip osteoarthritis and dyslipidaemia. She l...

A 34-year old lady with a history of Crohn’s colitis and depression presented to the Emergency Department (ED) reporting an allergic reaction to azathioprine. She complained of mild headache, anxiety and nausea but denied wheeze, shortness of breath, tongue swelling or rash. Her medications were prednisolone, predfoam enemas, escitalopram, combined oral contraceptive pill (OCP) and azathioprine, commenced one month ago. She denied alcohol or recreational drug consumption....

Background: Hyponatraemia is a frequent finding in medical inpatients, where a comprehensive evaluation is warranted to establish the underlying mechanism and guide further management. Whilst the role of confounding medications, syndrome of inappropriate anti-diuretic hormone (SIADH), adrenal insufficiency and polydipsia is well-established as causative factors in the development of hyponatremia, the link between hypothyroidism and hyponatremia is controversial in the medical ...

A 56-year-old male presented in 2017 with acute symptomatic hyponatraemia. He was admitted with a seizure and a plasma sodium of 112 mmol/l. His past medical history was notable for alcohol excess and smoking. The acute presentation was managed with 3% hypertonic saline infusion in ITU. Plasma osmolality was 240 mOsm/Kg, urine osmolality 327 mOsm/kg and sport urine sodium 28 mmol/l. CT TAP showed some oesophageal thickening only; endoscopy was normal. He made a good recovery f...