Endocrine Abstracts

Introduction: Pancreatitis due to hypercalcemia from primary hyperparathyroidism is rare with an incidence of 1–1.5%. We report on a case of recurrent pancreatitis secondary to an ectopic parathyroid adenoma with co-existing severe vitamin D deficiency with its management difficulties.Case report: A 45-year-old male admitted to the hospital with abdominal pain and attendant nausea had investigations ruling out structural lesions for his symptoms but...

A 79-year-old man presented with a fall and vomiting. The finding of significant postural hypotension associated with severe hypotonic hyponatraemia (Na 114 mmol/L, Osmolarity 244 mmol/L) mandated a Short Synacthen Test (cortisol 98 mmol/L at baseline and 238 mmol/L 30-minute post synacthen) and ACTH (6 ng/L) which confirmed central hypoadrenalism. This led to revelation of multiple pituitary axes involvement: hypogonadism (testosterone 1...

A 79-year-old man presented with a fall and vomiting. The finding of significant postural hypotension associated with severe hypotonic hyponatraemia (Na 114 mmol/L, Osmolarity 244 mmol/L) mandated a Short Synacthen Test (cortisol 98 mmol/L at baseline and 238 mmol/L 30-minute post synacthen) and ACTH (6 ng/L) which confirmed central hypoadrenalism. This led to revelation of multiple pituitary axes involvement: hypogonadism (testosterone 1...

Adrenal haemorrhage is a serious condition that can result in adrenal insufficiency, shock, acute adrenal crisis, and mortality if not managed with adequate treatment. Hereby we present two cases of non-traumatic bilateral adrenal haemorrhage highlighting their management during the acute phase.Case 1: 57 year old female presented due to chest pain, palpitations and troponin rise with a background history of antiphospholipid syndrome on anticoagulation. ...

Introduction: Adrenal vascular cysts are rare, in most cases incidentally discovered during abdominal imaging for other reasons. We present a case of adrenal endovascular cyst with initial suspicious features of adrenal malignancy and subsequent management and complications.Case report: This 72-year-old male was initially admitted with a weight loss over 2 months and new onset fever and rigors and right leg pain. He was noted to have an abdominal mass. H...

A 60 year old Caucasian woman was referred to endocrine clinic with persistent hypercalcaemia between 2.8 and 2.9 mmol/l (2.2–2.6), with inappropriately normal PTH at 7 pmol/l (1.48–7.63). Her hypercalcaemia was noted first in 2008. She had no signs or symptoms associated with hypercalcemia. However, she has a strong family history of hypercalcaemia, where her mother required Cinacalcet to control her hypercalcaemia despite two previous parathyroid resections. She ha...

We report a 77 year old male who presented to the respiratory clinic with episodes of periodic sweating. These episodes were associated nausea. They came on with exercise and always occurred before meals. The resolving factor noted by the patient was food intake and no features suggestive of reactive hypoglycaemia were noted. His past medical history was significant for hypertension, mild bronchiectasis, mild to moderate obstructive sleep apnea requiring CPAP therapy and ische...

Case history: A frail 79 years old lady with dementia presented with frequent falls since 2 years ago. Neurologist’s assessment had attributed her fainting episodes to migraine. She later was found to have biochemically evident recurrent hypoglycaemia requiring multiple admissions and eventually continuous glucose infusion to maintain euglycemia.Investigations: The severe spontaneous hypoglycaemia in this non-diabetic lady prompted investigations. T...

Case: A 79 years old frail lady with history of dementia and hypertension presented with refractory hypoglycaemia over a period of 3 months requiring multiple admissions. During her most recent admission, she required continuous dextrose infusion to maintain euglycaemia. The severe spontaneous hypoglycaemia in this non-diabetic lady, warranted a series of investigations. TFT and Short Synacthen Test excluded thyroid dysfunction and hypoad...

Case: A 79 years old frail lady with history of dementia and hypertension presented with refractory hypoglycaemia over a period of 3 months requiring multiple admissions. During her most recent admission, she required continuous dextrose infusion to maintain euglycaemia. The severe spontaneous hypoglycaemia in this non-diabetic lady, warranted a series of investigations. TFT and Short Synacthen Test excluded thyroid dysfunction and hypoad...