Endocrine Abstracts

We present a case of a 54-year-old man who was urgently referred to A&E by his general practitioner with very low calcium of 1.32 mmol/l (normal 2.20–2.60 mmol/l). His only past medical history of note was of recently diagnosed multiple sclerosis (MS), which presented as optic neuritis six months ago. His initial investigations included high phosphate level of 2.0 mmol/l (normal 0.8–1.5), normal vitamin D levels (76 mmol/l) and a very low 24-hour urine calcium of...

Hyperthyroidism is associated with multiple gastrointestinal (GI) symptoms including vomiting, although this is not very common. We present a case of a 61-year-old female patient, who was admitted under surgeons with persistent and severe vomiting which was very difficult to manage. No acute surgical cause for vomiting was found and the patient was referred for a gastroscopy which was normal. Her past history was significant for Grave’s disease which was in ...

Hyperthyroidism is associated with multiple gastrointestinal (GI) symptoms including vomiting, although this is not very common. We present a case of a 61-year-old female patient, who was admitted under surgeons with persistent and severe vomiting which was very difficult to manage. No acute surgical cause for vomiting was found and the patient was referred for a gastroscopy which was normal. Her past history was significant for Grave’s disease which was in ...

Hirsutism is an endocrine condition affecting females with growth of unwanted, male-pattern hair secondary to excess androgen activity. The most common cause of hirsutism in females is PCOS (Polycystic ovarian syndrome). Other causes are fairly rare including adrenal and ovarian androgen producing tumours. In 3% of cases no cause of hirsutism is found and these are termed idiopathic1. We describe a unique case of a 22-year-old presenting w...

Hirsutism is an endocrine condition affecting females with growth of unwanted, male-pattern hair secondary to excess androgen activity. The most common cause of hirsutism in females is PCOS (Polycystic ovarian syndrome). Other causes are fairly rare including adrenal and ovarian androgen producing tumours. In 3% of cases no cause of hirsutism is found and these are termed idiopathic1. We describe a unique case of a 22-year-old presenting w...

Case history: A 43-year-old man was admitted to Intensive care with life-threatening pneumonia, along with acute hypertension and hypokalaemia. There were several Cushingoid clinical features, therefore ectopic ACTH syndrome was suspected.Investigations: The diagnosis of severe ACTH-dependent Cushing’s syndrome was confirmed with unsuppressed cortisol after low dose dexamethasone (763 nmol/l with ACTH 131 ng/l, 24-h urinary cortisol levels (x2) of >...

Toxic adenomas nodules rarely harbour cancer. Fine needle aspiration (FNA) is often not done due to the rarity of these lesions being cancer, the difficulty in interpreting cytology in hyperthyroid patients and the rarely reported instance of precipitating thyrotoxicosis. Here, we present two young Caucasian female patients with toxic adenomas, who underwent hemithyroidectomy and the histology unexpectedly revealed differentiated follicular cancer. The first is a 29-year-old p...

Objective: To analyze the effect of DM on frequency and severity of HE in patients with liver cirrhosis.Methods: Three hundred and fifty-two patients with liver cirrhosis were prospectively assessed for severity of liver disease and presence of DM in a multicenter study. The presence and severity of HE was determined using West Haven criteria. Kolmogorov-Smirnov Goodness-of-Fit Test was used to check normality of continuous variables. Modified Child Pugh...

Aim: The aim of this study was to estimate the frequency of SMBG among patients attending a tertiary care hospital and to evaluate the impact of SMBG on glycemic control in participants with diabetes mellitus.Method: A random sample of 174 patients was selected for accrual in the study from the diabetic clinic of Nishtar Medical College Hospital Multan. Patients were interviewed using a structured questionnaire to elicit information about their self mana...

High grade pancreatic NETs are usually non-functional. Here, we report a case of a patient with a high grade pancreatic NET, which was initially non-functional but became functional after chemotherapy. He was initiated on a flash glucose monitoring device (FreeStyle Libre®) avoiding the need for frequent capillary blood glucose monitoring. Using this novel approach, we demonstrated an improvement in his disabling hypoglycaemia with medical treatment. A 45-year-old profess...