Endocrine Abstracts

Case History: A 58 year old female was referred by the GP to hospital for symptoms of tingling and numbness in fingers and toes, muscle cramps in arms and legs and swollen legs. The patient had a history of gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), hypertension, fibromyalgia, iron deficiency anaemia, knee osteoarthritis, and heart failure.Investigations: On admission, a corrected calcium level was 1.9 mmol/l and serum magnes...

Case history: This 55 years old gentleman has past medical history of obesity, type 2 diabetes (since age of 27 yrs.), hypercholesterolemia, hypertension and osteoarthritis. He recently suffered from myocardial infarction discharged 2 days back and presented to emergency department with central chest pain radiating to both arms in the morning. Investigations: ECG reported as normal and venous blood gas showed pH- 7.10, pCo2- 3.84, pO2- 5.54, glucose- 10,...

Case History: A 58 year old female was referred by the GP to hospital for symptoms of tingling and numbness in fingers and toes, muscle cramps in arms and legs and swollen legs. The patient had a history of gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), hypertension, fibromyalgia, iron deficiency anaemia, knee osteoarthritis, and heart failure. Investigations: On admission, a corrected calcium level was 1.9 mmol/l and serum magne...

Insulinoma is an insulin-secreting tumour of beta cells resulting in hypoglycemia. This rare tumour presents with hypoglycemic symptoms and can be easily confused with transient ischemic attack or epilepsy or delirium. The diagnosis of an insulinoma is usually made biochemically and confirmed by localizing the tumour with imaging. We present this case of a 56 years old woman who repeatedly presented to emergency for her symptoms of diplopia and word finding difficulty. She als...

Hypercalcaemia (calcium level >2.63 mmol/L) is a common metabolic condition. In spite of its diverse aetiologies, primary hyperparathyroidism and malignancy account for more than 90% of cases, parathyroid adenoma alone contributing to 80–85% of parathyroid related cases. We describe a case of resistant hypercalcemia in a 75-year-old Afro- Caribbean gentleman.He presented with a 2-month history of constipation, loss of appetite & gradual weig...

Synthetic levothyroxine (L-Thyroxine) is the treatment of choice for hypothyroidism. It is safe, effective and generally well tolerated. Some patients, however, cannot tolerate L-Thyroxine. There is still some controversy about the effectiveness of combination T4 & T3 therapy. We describe 3 patients who were successfully treated with Armour thyroid (pork extract of T4 & T3) after being intolerant to L-Thyroxine.A 35 yr old lady initially presente...

Introduction: Vitamin D deficiency/insufficiency in patients with primary hyperparathyroidism may be associated with more severe and progressive disease. In such patients there is higher levels of parathormone and markers of bone turnover, large parathyroid adenomas and more frequent fractures than vitamin D replete patients.Aims and objectives: To determine whether vitamin D repletion of patients with PHPT and co-existing vitamin D insufficiency or defi...

Case history: We present the case of a 40-year-old man who was referred to a cardiologist with hypertension. He was initiated on bisoprolol and doxazosin. Investigations revealed elevated urinary metanephrines and catecholamines, with normetadrenaline 7.4 μmol/24 h (normal <2), noradrenaline 820 nmol/24 h (normal <500) but normal dopamine levels. He was referred to our clinic. Two further 24 h urine catecholamine assays were elevated. Dexamethasone suppression tes...

Hypoglycemia is not uncommonly encountered in healthy type 1 diabetics. It has diverse etiologies but food-insulin mismatch, exercise, drugs, co-existing adrenal, thyroid and coeliac disease, neuro-endocrine tumours & factitious hypoglycemia are the most common causes.We describe the case of a 23-year old Caucasian male with type 1diabetes of 3-years duration with recurrent episodes of unexplained hypoglycemia. He was otherwise well and denied any sy...

Introduction: Latent Autoimmune Diabetes of Adult (LADA) is a form of adult onset type1diabetes. It usually presents after age 30 years and has many demonstrable antibodies, Glutamic Acid Decarboxylase (GAD) being one of them. Detection of LADA has definite prognostic and treatment implications as 10% of adults with diabetes in UKPDS had LADA and majority of them required insulin within 6 years of diagnosis. Screening by using GAD antibody has been said to be a superior method...