Endocrine Abstracts

Malignancy-related hypercalcaemia occurs in over 20% of cancer patients. Most cases are due to enhanced production of parathyroid hormone-related peptide (PTHrP) by tumours and carry a poor prognosis of survival of weeks to months. A 74 year old man with a history of prostate cancer treated with radical radiotherapy in 2013 and androgen blockade until 2015 underwent CT and PET/CT scans in 2017, which showed liver and spleen abnormalities, suggestive of metastases, but unlikely...

Case: A 25-year-old male with a history of Asperger’s syndrome, not on regular medication, with no family history of endocrinopathy; was referred with mild hypercalcaemia found during routine investigations for fatigue, weight loss, diarrhoea and vomiting. A normal PTH suggested PTH-dependent hypercalcaemia. There was no history of fractures or nephrolithiasis. DEXA scan showed normal bone mineral density (femur, spine and forearm). The gastrointestinal symptoms and fatig...

Background: Hypercalcemia in patients with advanced chronic liver disease (CLD) without hepatic neoplasia is a rarely reported and poorly understood entity. CLD is usually associated with hypocalcaemia because of hypoalbuminemia. Hypercalcemia on the other hand is extremely rare and needs meticulous ruling out of other causes.Case Report: A 55-year-old male who was admitted with jaundice, weight loss and hypercalcaemia. He had a calcium that peaked at 3....

Kennedy’s Disease (KD) or Spinal and Bulbar Muscle Atrophy is a rare X-linked recessive condition due to CAG repeat in the androgen receptor (AR) gene. KD affects males with unaffected female carriers. Reported prevalence in male populations is highly variable; recent data suggests 2.5 in 100,000 with region specific higher prevalence. KD manifests as androgen insensitivity (AI) with features including gynaecomastia and motor signs such as early tremor, facial an...

Case: A 69 year old man was diagnosed with poorly differentiated pancreatic adenocarcinoma with liver metastases in November 2017 and received FOLFIRINOX chemotherapy followed by Gemcitabine. This stabilised his disease and chemotherapy was stopped in March 2020. In April 2021 he presented with a 3-4 month history of tiredness; intermittent confusion, especially in the early morning; the discovery that food resolved his symptoms, albeit temporarily; and accompanying significan...

Introduction: There are patients who remain symptomatic with hypothyroidism despite apparent adequate replacement on levothyroxine (LT4) therapy. We present an observation where monozygotic twins responded only to combination therapy with liothyroinine (LT3), and were found to have a genetic variation which may have clinical significance in thyroid metabolism.Case report: A 47-year-old female with polyglandular auto-immune syndrome (APS1) presented with ...

A 50 year old Asian lady developed neck pain and sore throat 10 days after first dose of AstraZeneca COVID-19 vaccination. Her dentist thought she had tonsillitis. She then presented to hospital a few days later with dyspnoea, palpitations, tremor and neck pain. She was apyrexial but clinically thyrotoxic with sinus tachycardia. Thyroid gland had normal size with tenderness without bruit or lymphadenopathy. Her Free T4 was >100 pmol/l (11.2 - 20.2), TSH < 0.01mIU/l, ES...

Case presentation: A 40-year-old Caribbean woman presented with sudden onset palpitations. She described 3 months of progressive shortness of breath, non-productive cough and 7kg weight loss. She denied chest pain, fevers or night sweats, but reported increased stool frequency, gritty eyes, and occasional visual blurring. She appeared cachectic and had a fine tremor, left eye proptosis and a visible pulsatile goitre. She was afebrile, tachypnoeic, hypoxic, hypotensive with fas...

We report the case of a previously healthy, 40 years old obese male, who was admitted in emergency with complaints of chest pain, shortness of breath and loose stools. His physical examination was relatively unremarkable except for sinus tachycardia and restlessness. He had no history of ischemic heart disease. He was admitted under cardiologists and had various investigations (echocardiogram, stress test and coronary angiogram), all normal. Due to the presentation, thyroid fu...

A 29 year old woman with multiple sclerosis and no history of thyroid dysfunction was referred to endocrinology with T3 thyrotoxicosis (TSH <0.01 mU/l, fT4 20.7 pmol/l, T3 2.9 nmol/l). She had received monoclonal alemtuzumab therapy 9 months prior. This hyperthyroid phase was short lived and in the absence of anti-thyroid medication developed symptomatic hypothyroidism within 2 months of referral (TSH 52.9 mU/l, T4 <5 pmol/l, T3 0.8 nmol/l). Thyroid receptor antibodies...