Endocrine Abstracts

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...

A 57 year old man presented with a 2 year history of erectile dysfunction and loss of libido. He was able to achieve erections but could not maintain them for intercourse. This was causing considerable strain on his marital life. He also complained of lethargy and general fatigue. His past medical history included diet-controlled type 2 diabetes and hypertension. He was an ex-smoker with a 40 pack year history and drank socially. He was an office worker. He had 3 grown up chil...

A 72 year old lady was referred after recurrence of fragility fractures, despite being on bisphosphonate therapy for 10 years. She had 2 low-impact falls in 2020 and 2021, which resulted in hip and right distal femur fractures respectively. She had been compliant on alendronic acid 70mg once weekly since 2012, when she was diagnosed with osteoporosis at the age of 62, after sustaining 2 fragility fractures of the distal radius and elbow after separate low-impact falls. DXA sca...

A 25 year old Afro-Caribbean man was referred for adrenal vein sampling for suspected Conn’s syndrome and the finding of a right adrenal nodule. He initially presented to his local hospital with vomiting. He had hypokalaemia, which persisted even after the vomiting had resolved. He required oral potassium supplementation to maintain a normal serum potassium level. He gave a history of fatigue and occasional muscle cramps during the last 3 years. Intermittent spontaneous h...

Lithium is commonly used for management of Bipolar disorders. Li-induced thyroid dysfunction, including hypothyroidism and goitre are the most prevalent while hyperthyroidism is very infrequent, mainly characterised by transient painless thyroiditis but it increases the propensity to thyroid autoimmunity in susceptible individuals. Thyroid profile, thyroid auto-antibodies, assessment of thyroid size should be performed among patients initiating lithium, at baseline and later a...

A 25 year old lady initially presented with symptoms of palpitation, irregular menses and unintentional weight loss. She was a non-smoker with no current pregnancy plans or family history of thyroid disease. On examination, she was tachycardic and had a moderate diffuse goitre but no signs of thyroid ophthalmopathy. She was biochemically hyperthyroid (TSH <0.01 mIU/l, fT4 30.0 pmol/l, fT3 >30.7 pmol/l). Carbimazole 30 mg daily was started for likely Graves’ diseas...

Iron is a transition metal that acts as an oxidant. There is evidence that systemic iron overload could contribute to abnormal glucose metabolism. Further research has showed that iron overload can result in an increased in type 2 diabetes irrespective of the cause of gene involved. Although the exact mechanism of iron-induced diabetes is uncertain, it is likely mediated by these three mechanisms: i) insulin deficiency, ii) insulin resistance, and iii) hepatic dysfunction....

Introduction: Hypocalcemia is a well known adverse reaction of phosphate supplements but rarely reported. We report a case of Infant presenting with hypocalcemic seizures after initiation of phosphate supplements.Clinical case: A baby Girl was born at 34+4 weeks gestation. She was admitted in NNU for preterm care. The admission was complicated by severe Gastroesophageal reflux disease(confirmed by PH impedance study), anemia and sepsis. She was discharge...

Introduction: Hypercalcemia is a common clinical abnormality seen in clinical practice. One of the leading causes of hypercalcemia is Primary hyperthyroidism from a parathyroid adenoma. While the ectopic parathyroid tissue is typically found in the thymus and anterior mediastinum, Intrathyroidal parathyroid adenoma is a challenging cause of primary hyperparathyroidism leading to persistent hypercalcemia even post-surgery.Case His...

Background: Hypercalcemia is not uncommon in granulomatous disorders, especially sarcoidosis and tuberculosis. Prevalence in sarcoidosis may be 2-63%, depending on the population studied. Uncontrolled synthesis of 1,25-dihydroxyvitamin-D by the macrophages is the underlying mechanism. Here we present a case of hypercalcemia, initially thought to be due to hypervitaminosis-D but later diagnosed to have sarcoidosis.Case Presentation: This 49-year-old gentl...