Endocrine Abstracts

Case History: We report the case of a 25-year-old Asian male who presented to our hospital with recurrent episodes of abdominal pain complicated by significant Hyponatremia. Initial admission was in November 2021 followed by March, 2022 with similar symptoms. He remained under surgical care during both admissions. For his severe hyponatremia, an urgent Endocrine input was sought. The patient was not on any medications that could be implicated in his biochemical picture and his...

Introduction: 46,XX disorder of sexual development (DSD) is a rare cause of sex reversal. Only a few hundred cases have been described. The clinical spectrum can be divided into 3 groups of males according to genital appearance: normal male, atypical variants such as hypospadias or cryptorchidism, and those with both male and female genitalia.Subcategories of 46,XX DSD include ovotesticular DSD, which is characterised by the presence of both testicular a...

Background: Histoplasmosis is an opportunistic fungal infection that commonly affects immunocompromised individuals. Histoplasmosis may be asymptomatic or may present with progressive systemic manifestations (pulmonary or disseminated). We present a case of a 76 year old immunocompetent man presented to hospital with 8 weeks history of general malaise and lethargy, intermittent night sweats, a productive cough, weight loss of 2.5 stones in two months and low grade fever. He ha...

A 40 years old man with a diagnosis of Adrenoleukodystrophy (ALD) was referred for evaluation of symptoms suggestive of hypogonadism. He had a past medical history of ALD associated adrenal insufficiency and osteoporosis. He took regular hydrocortisone and a trial medication, MD1003.Following review, post clinic blood tests revealed a testosterone 24.5 nmol/l (7.6–31.4), LH 8.8 IU/l (1.7–8.6) and FSH 1.5 IU/l (1.5–12.4). Thyroid function t...

A 79-year-old female patient, with a background history of hypertension and ischaemic heart disease was brought by ambulance to hospital with near collapse episode associated with capillary blood glucose (CBG) of 2.1 mmol/l. Her regular medications include Ramipril, clopidogrel and atorvastatin. She had no history of diabetes. While inpatient, it was observed that majority of low capillary blood glucose readings (CBG) were late night or early mornings. At venous glucose of 1.9...

A 33 year old white European patient presented at 32 weeks gestation with a three day history of severe epigastric pain radiating to left flank with vomiting. She had pre-existing hypertension, controlled with labetalol. On admission, her BP dropped from 170/100mmHg to 90/70mmHg. Abdominal examination revealed epigastric tenderness without peritonism. There were no Cushingoid features. An abdominal ultrasound scan was normal. An MRI scan showed a bulky left adrenal gland, with...

63 years old with sarcoidosis since 2018 and type 2 diabetes was referred by GP for hypercalcemia related to likely dehydration and sarcoidosis. She was started on a weaning dose of prednisolone and empagliflozin. She had already been on metformin for several years. She was discharged after calcium improved from 2.97 mmol/l to 2.83 mmol/l. She was advised to follow up in Ambulatory care in 1 week for repeat calcium levels. On follow up, noted to have calcium levels of 2.67 mmo...

45 years old male of Romanian origin presented with shortness of breath and reduced exercise tolerance over 3 months with increased sweating and weight gain from 90 kgs to 118 kgs over 2 years. Also reported hands/fingers/feet size increase. He also complained that his breathlessness worse by as tongue and lips were ‘large’. Denied any visual disturbance, especially peripheral vision. On examination, coarse features, prognathism and possible macroglossia noted. Photo...

The role of magnesium in electrolyte homeostasis is well established. ATP/ADP structure, refractory hypokalemia and calcium homeostasis are some of the established roles in literature, well known to Endocrine. However, currently no NICE guidelines exist for low magnesium. Our first audit in 2018 focused on patient admissions during January 2018. We found 49 patients with Mg < 0.5. Majority were care of the Geriatrics, 8 under Gastroenterology, 4 under Endocrinology. 31 pat...

A 25 year old Afghan male presented with a 4 day history of worsening left-sided loin pain. He had a past history of deafness since birth, speech problems and development delay. Bilateral renal calculi and widespread multiple well defined lytic lesions (likely brown tumours) were seen on CT-KUB. The corrected calcium was 3.21 mmols/l, PTH 80 pmol/l, Vitamin D 25 nmol/l, phosphate 0.49 mmols/l, ALP 960 IU/l and fractional calcium excretion was 0.16. His skull X Ray/OPG, done du...