Endocrine Abstracts

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) occurs in 10-45% of patients and secretion of ectopic adrenocorticotrophic hormone (EAS) in 2.5% of patients with small cell lung cancer (SCLC). Simultaneous secretion of ADH and ACTH is rare with only 10 cases being reported. The varying biochemical data leads to misdiagnosis as this case demonstrates. A 67 year old male presented with a 2 week history of falls attributed to alcohol abuse. Physical signs ...

Gitelman’s syndrome (GS) is an autosomal recessive renal tubular disorder caused by mutations of the SLC12A3 gene coding for the thiazide-sensitive sodium chloride co-transporter (NCCT). Hypokalaemia, hypomagnesaemia, hypocalciuria and metabolic alkalosis are consequent. Sjorgren’s syndrome (SS) is a connective tissue disorder primarily affecting lacrimal and salivary glands resulting in sicca complex. The coincidental presence of both syndromes is rare. A 28 year ol...

The classic episodic triad of headache, sweating and palpitations facilitates the diagnosis of phaeochromocytoma. The absence of these symptoms can lead to misdiagnosis in patients with uncommon symptoms attributable to phaeochromocytoma. We present such a case.Case report: A 64 year old man was referred to endocrinology having been coincidentally found to have a right adrenal mass with features of a phaeochromocytoma. He was asymptomatic and engaged in ...

The non-specific symptoms of Addison’s disease may be attributed to other conditions with consequent delay in diagnosis. We describe such a case of novel presentation. A 61 year old female presented with a one-day history of vomiting, abdominal pain and 15kg weight loss over 6 months. PMH: hypertension of 15 years duration, chronic kidney disease (CKD3) for 7 years and hysterectomy for endometrial carcinoma 8 years earlier. Examination: dehydrated, sinus tachycardia 110 b...

Spontaneous resolution of primary hyperparathyroidism following infarction for parathyroid adenomas is rare with infarction on treatment with cinacalcet being even rarer. A 53 year old female who presented to primary care with malaise was found to have biochemical evidence of primary hyperparathyroidism with adjusted calcium 3.31 mmol/l and parathyroid hormone 28.8 pmol/l. Previous medical history was unremarkable. Following discussion with endocrinology, treatment with cinaca...

A third of people over the age of 65 and half of those over 85 fall at least once a year. Aside from the human cost, the cost to the NHS is an estimated £2 billion/year and 4 million bed days (2014 figures). Hyponatraemia in the elderly is associated with falls, fractures, morbidity and mortality. Previous studies have demonstrated decreased activity of renin-angiotensin-aldosterone system with increasing age. More recent studies have suggested dysregulation of aldosteron...