Endocrine Abstracts

A 30-year-old lady was initially seen in our clinic with a slight elevated corrected calcium with an elevated parathyroid hormone in March 2021. The elevated calcium [2.58mmol/l(NR: 2.10-2.55)] was first noted in 2018 when she had investigations for easy bruising, fatigue, breathlessness, and weight loss. The symptoms settled on their own and her calcium levels were monitored routinely. She was referred to our clinic when the corrected calcium had increased to 2.69mmol/lwith a...

Case Summary: A 53-year-old lady who was normally fit and well, presented with a 3 months history of polydipsia and excessive polyuria up to 13 litres a day. A water deprivation test confirmed a cranial diabetes insipidus, and she was started on desmopressin. Apart from hypothyroidism that was well controlled with levothyroxine replacement, the rest of her pituitary profile was unremarkable for a lady of her age. The rest of her investigations showed persistent increased infla...

Background: Primary hyperparathyroidism is the commonest cause of hypercalcemia. Current guidelines advise to rule out familial hypocalciuric hypercalcemia (FHH) when evaluating hypercalcemia. It is widely considered that FHH is associated with low urine calcium creatinine clearance ratio (CCCR). However, low CCCR can also occur in Primary hyperparathyroidism.Case: A 30 years lady presented with hypercalcemia and high parathyroid hormone (PTH). She had a...

Background: Hypothalamus pituitary adrenal axis (HPA) dysfunction is associated with serious morbidity and mortality. Its symptoms can be non-specific. Objective diagnosis depends on clinical suspicion and confirmed on assessment of early morning cortisol or dynamic assessment of cortisol secretion. The cosyntropin or short synacthen test (SST) has emerged as the most common test to assess the HPA. The insulin stimulation test (IST) is the traditional ‘gold standard’...

Background: Myasthenia gravis and thyroid disease can sometimes create diagnostic confusion because the two may have similar clinical features and may also co-exist in the same individual.Case: A 68 years male, was seen in the Neurology clinic with drooping of his left eyelid, first noticed 8 months prior, worse in the evenings. There were no other complaints. He had history of type2 diabetes, and Graves’ disease. On examination, he appeared to have...

Background: Newer biological drugs such as immune checkpoint inhibitors (ICI) have recently revolutionized cancer therapy. However, hypophysitis and adrenalitis are recognized side-effects of these new therapies. Hypothalamus pituitary adrenal (HPA) axis dysfunction is associated with serious morbidity and mortality. This study aimed to monitor whether the ICI related HPA axis dysfunction recovers.Materials and Methods: We have conducted a retrospective ...