Endocrine Abstracts

Introduction: Hypoparathyroidism may be an isolated or a component of a complex syndrome. Although genetic disorders are not the most common cause, molecular analyses have identified a growing number of genes that when defective result in impaired formation of the parathyroid glands, disordered synthesis or secretion of parathyroid hormone.Case presentation: We are reporting a 37-year-old gentleman, who is the first adult case diagnosed at our University...

History: We present the case of a 47-year-old man with heart failure (HF) and cranial diabetes insipidus (CDI) secondary to Langerhans-cell-histiocytosis. In the context of worsening HF with increasing shortness of breath and fluid retention, careful desmopressin dose reduction provided adequate aquaresis to restore euvolemia, obviating the need for usual diuretic treatments.Investigations: Echocardiography and a cardiac MRI revealed a non-dilated but se...

Hypophosphatemia is commonly missed due to nonspecific signs and symptoms. It can cause muscle weakness, confusion, white blood cell dysfunction and disrupt cardiopulmonary systems. Three main mechanisms of hypophosphatemia are shifts from the extracellular to intracellular compartment, increased renal excretion and decreased intestinal absorption. Here we report a case of symptomatic hypophosphatemia post ferric carboxymaltose (Ferrinject) infusion. A 42 year old lady with lo...

This is the case of a now 37 years old female. She was diagnosed with classical salt wasting congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency at 1 week after birth. She highlights the challenges of living with CAH. She struggled all through her childhood and adolescence with the burden of treatment, difficulties with compliance and the effects of the inadequate control of hyperandrogenism. In adulthood supraphysiological doses of exogenous steroids lead to...

Insulinomas are neuro-endocrine tumours of the pancreas with an incidence of 0.7-4 cases per 1,000,000 population per year. Type 1 diabetes has an incidence of >20 cases per 100,000 per population per year. Cases of insulinoma with diabetes are lower than in the general population with a type 2 preponderance. This report is the seventh of insulinoma with type 1 diabetes suggesting the latter inhibits the development of the former. A 31 year old female with a 20 year histor...

Introduction: Avascular necrosis of the femoral head (AVN) is most commonly a consequence of glucocorticoid excess and is believed to be due to osteocyte apoptosis. It can also be due to vascular occlusion or trauma. We describe a patient with congenital adrenal hyperplasia secondary to 17-hydroxylase deficiency who presented with osteoporotic vertebral fractures and atraumatic avascular necrosis of the femoral head. She was also found to have mild cardiomyopathy.<p class=...

Introduction: Thionamides are the mainstay of management of thyrotoxicosis but can be associated with adverse effects like agranulocystosis, hepatitis and vasculitis. While radioactive iodine and thyroidectomy can be utilized in such scenarios, they were not timely available during the COVID pandemic. We present our experience of using cholestyramine as monotherapy.Case Series: Our series consists of four females. Graves’ disease was the underlying ...

Presentation: A 20 year old student was brought to the Emergency Department with a 13 day history of heavy menstrual bleeding. On the day of her admission she had collapsed. On admission, she was noted to be pale with severe postural drop (70 mm Hg).Investigations: Haemogobin: 46 g/l. Blood film showed an iron-deficient picture. eGFR: 54ml/min/1.73m2. Creatinine: 124 μ mol/l. Free T4: <5.3 pmol/l. TSH: >500 mU/l. TPO antibodies positive (8.3...

Introduction: The prevalence of gynaecomastia ranges between 40-60% and the majority of cases are asymptomatic, commoner among obese and is due to excess circulating oestrogen. Ovo-testicular disorders of sex development (OT-DSD) is one of the rarest disorders of DSDs and commonly presents with bilateral intra-abdominal gonads and ambiguous external genitalia.Case presentation: A 15 years old male presented with progressively worsening bilateral gynaecom...

Introduction: Carcinoid heart disease can occur in up to 20 % of patients with carcinoid syndrome. It is a regarded as a rare complication and associated with high morbidity and mortality as a sequela of vasoactive peptides resulting in plaque formation on the valve leaflets classically tricuspid and pulmonary valves and causing right heart failure. Definitive treatment is surgical valve replacement, but percutaneous valve management is an attractive alternative for those deem...