Endocrine Abstracts

Amiodarone is commonly prescribed anti-arrhythmic drug which can lead to thyroid dysfunction manifesting as either hypothyroidism or hyperthyroidism. This clinical case of amiodarone induced thyrotoxicosis is being reported to highlight the challenges faced during its management. A 72-year-old gentleman was admitted with history of recurrent falls. He had past medical history of non-ischemic cardiomyopathy, CRT, atrial fibrillation, vascular dementia, osteoporosis, primary hyp...

Ectopic ACTH is an infrequent cause of Cushing’s syndrome which can be severe in its presentation and needs immediate management to in order to prevent the complications associated with severe hypercortisolism. This case of ectopic ACTH secretion is being reported who presented clinically as Cushing’s syndrome and later diagnosed to have small cell carcinoma of lung. A 62-year-old previously normally fit and well lady presented with 1-month history of feeling unwell,...

Hypoparathyroidism following parathyroidectomy is commonly treated with activated vitamin D, (alfacalcidol and calcitriol). Alfacalcidol (1-hydroxyvitamin D) is converted by hepatic 25-hydroxylase to generate calcitriol (1,25-dihydroxyvitamin D) to act on target cells.We present the case of 66 year old man who was admitted with chest pain in November 2016 and found to have corrected calcium of 1.5 mmol/litre and PO4 2.7 mmol/litre....

Hypoparathyroidism following parathyroidectomy is commonly treated with activated vitamin D, (alfacalcidol and calcitriol). Alfacalcidol (1-hydroxyvitamin D) is converted by hepatic 25-hydroxylase to generate calcitriol (1,25-dihydroxyvitamin D) to act on target cells.We present the case of 66 year old man who was admitted with chest pain in November 2016 and found to have corrected calcium of 1.5 mmol/litre and PO4 2.7 mmol/litre....

Introduction: Hypocalcaemia is a frequent complication after thyroid and parathyroid surgery. We report a case of tetany occurred in a patient with normal serum levels of calcium, magnesium and phosphate after parathyroidectomy for hyperparathyroidism.Case History: 55 year old Caucasian male was referred by general physician with three month history of fatigue, loss of appetite, intermittent constipation and abdominal pain. Systemic examination unremarka...

Introduction: Thyrotoxicosis is a common endocrine disorder; variable degree of hepatic dysfunction is often seen with thyrotoxicosis. Severe liver dysfunction associated with thyrotoxicosis occurs rarely. The prevalence of liver abnormality with thyrotoxicosis is reported to be ~ 15–30%. The mechanism of liver abnormality is not well understood; direct thyroid hormone mediated hepatocyte injury has been raised as a possible mechanism. We conducted a retrospective review ...

A 30 year-old Caucasian male presented for a routine check-up. He was known to have abnormal thyroid function tests since the age of 23 years of unclear nature/aetiology. He reported occasional palpitations and anxiety. There were no other symptoms on systems’ review. He did not take regular medication, was an ex-smoker and consumed alcohol socially. His mother had hypothyroidism and his maternal aunt’s thyroid nodules. He was euthyroid. A palpable isthmic nodule &#7...

Case history: Cyclical Cushing’s is a very rare disease with rhythmic fluctuations in cortisol production with or without phenotypic features. It is a very challenging entity to diagnose. The low index of clinical suspicion is key for timely diagnosis and prevention of long-term complications. A 66 years old male presented with intermittent, episodic bilateral leg swelling and reversible weight gain of ˜6 kg following these episodes. Background history entailed femor...

Insulin Autoimmune Syndrome (IAS)/Hirata disease is a very rare condition in which anti-insulin antibodies result in accumulation of high circulating concentrations of insulin in complexes. Hypoglycaemia in IAS occurs when insulin is released from the antibodies during fasting. We present two contrasting cases of Hirata disease. Both patients presented with symptomatic hypoglycaemia. Patient-A is a 52-year old obese Thai female, with acanthosis nigricans and a strong family hi...

Introduction: Diabetes mellitus is as a major contributor to disease severity and mortality in patients with Covid-19 infection, as the estimated increase in risk of death in hospitalised patients is 3.5-times (for T1DM) and 2.03-times (for T2DM).This retrospective analysis recruited 35 patients from three London hospitals who presented with diabetic emergencies i.e. diabetic ketoacidosis (DKA), Hyperglycaemic hyperosmolar state( HHS), presence of ketone...