Endocrine Abstracts

Background: Hypercalcemia in patients with advanced chronic liver disease (CLD) without hepatic neoplasia is a rarely reported and poorly understood entity. CLD is usually associated with hypocalcaemia because of hypoalbuminemia. Hypercalcemia on the other hand is extremely rare and needs meticulous ruling out of other causes.Case Report: A 55-year-old male who was admitted with jaundice, weight loss and hypercalcaemia. He had a calcium that peaked at 3....

Background: Lactic acidosis is a common finding in critically ill patients. In patients with poorly controlled diabetes for a prolonged period of time, Glycogenic hepatopathy (GH), can cause lactic acidosis which is a rare condition that develops due to excessive accumulation of glycogen in the hepatocytes.Cases: Two cases with poorly controlled diabetes and glycogenic hepatopathy are presented. First patient was a 28 year old female with 20 year history...

Despite i.v. bisphosphonates, including pamidronate and zoledronate, representing the established agents used to reduce calcium levels, a proportion of patients with hypercalcemia either fail to respond to such treatments or relapse following their use.We present a case of hypercalcaemia refractory to conventional treatments that was treated with the use of the human MAB denosumab.A 70-year-old male presented to the emergency depar...

Postural orthostatic tachycardia syndrome (PoTS) reflects a disturbance of autonomic function leading to a myriad of clinical features. Subcutaneous octreotide injections and intramuscular long acting preparations of octreotide have been used in the treatment of PoTS. However, inconvenience of frequent injections, side effects and theoretical overexposure, as well as cost of the intramuscular preparation, makes them far from ideal.We present a case of un...

Assay interference with various laboratory measurements has been reported in the presence of paraproteins. We report a case of a 57 year old woman, who was referred to endocrine clinic after being found to have elevated total vitamin D levels of 369 and 336 nmol/l (normal 50–100 nmol/l). She was not known to be on any Vitamin D supplements that could account for such high levels. Around the time of referral, she was also diagnosed with IgM paraproteinaemia. Therefore, pos...

Assay interference with various laboratory measurements has been reported in the presence of paraproteins. We report a case of a 57 year old woman, who was referred to endocrine clinic after being found to have elevated total vitamin D levels of 369 and 336 nmol/l (normal 50–100 nmol/l). She was not known to be on any Vitamin D supplements that could account for such high levels. Around the time of referral, she was also diagnosed with IgM paraproteinaemia. Therefore, pos...

Introduction: Conn’s syndrome is a well-known cause of secondary hypertension; however, its association with pregnancy is rare. We discuss an interesting case of Conn syndrome presented with severe hypertension 8 weeks post-partum.Case report: A 34-years-old lady, previously fit and well, presented with severe hypertension (blood pressure–189/115 mmHg) and hypokalaemia (K-2.5 mmol/l) at 8 weeks post-partum. Antenatal records indicated she was n...

Background: We report a case of a 35-year-old male presenting with pituitary dysfunction secondary to an optochiasmal cavernoma.The gentleman was initially referred with gynaecomastia and biochemical tests consistent with secondary hypogonadism. On further questioning he also reported extremely lethargy, difficulties with weight loss and poor libido. Examination was consistent with features of hypogonadism with reduced body hair, bilateral gynaecomastia ...

Backgound: We report a case of a 63-year-old postmenopausal female diagnosed with ovarian hyperthecosis masked by concurrent use of an aromatase inhibitor.Following diagnosis of breast cancer in 2009, requiring mastectomy with adjunctive chemotherapy, she was commenced on anastrozole. Later she noted gradual onset of frontal balding and hirsutism. Biochemistry revealed elevated serum levels of testosterone 13.2 nmol/l (range: <1.9 nmol/l) and androst...

We report an interesting case of a rare presentation of hypercalcemia in a 27-year-old pregnant woman with history of Uterine fibroids. The patient arrived at the emergency department with two weeks history of worsening lower abdominal pain. She had resorted to sleeping in a sitting position due to the intensity of pain. There was no vaginal bleeding and bowels were not opened for four days. Physical examination revealed dehydration, tenderness in the lower abdomen with an abd...