Endocrine Abstracts

A 69 year old man presented to hospital with acute hypercalcaemia and renal failure. History included nephrectomy for a benign renal tumour and thyroidectomy for thyroid carcinoma. Presentation adjusted calcium was 2.70 mmol/L with an incompletely suppressed parathyroid hormone level of 0.6 pmol/L. The hypercalcaemia was resistant to both intravenous fluids and bisphosphonates, rising to 3.20 mmol/L. Given his previous cancer, hypercalcaemia of malignanc...

A 73-year-old lady presented with symptoms of weight-loss, tiredness, sweating and thyroid gland enlargement. Biochemistry demonstrated a T4 of 65.7 pmol/L and TSH <0.02 mmol/l. TSH receptor antibodies were positive confirming Graves’ disease. Thyroid ultrasound demonstrated reduced echogenicity and increased vascularity with a 3.2 cm left lobe U3 nodule and FNA planned.The patient developed a severe reaction within 17 days of star...

A 69 year old man presented to hospital with acute hypercalcaemia and renal failure. History included nephrectomy for a benign renal tumour and thyroidectomy for thyroid carcinoma. Presentation adjusted calcium was 2.70 mmol/L with an incompletely suppressed parathyroid hormone level of 0.6 pmol/L. The hypercalcaemia was resistant to both intravenous fluids and bisphosphonates, rising to 3.20 mmol/L. Given his previous cancer, hypercalcaemia of malignanc...

A 73-year-old lady presented with symptoms of weight-loss, tiredness, sweating and thyroid gland enlargement. Biochemistry demonstrated a T4 of 65.7 pmol/L and TSH <0.02 mmol/l. TSH receptor antibodies were positive confirming Graves’ disease. Thyroid ultrasound demonstrated reduced echogenicity and increased vascularity with a 3.2 cm left lobe U3 nodule and FNA planned.The patient developed a severe reaction within 17 days of star...

This 31 year old patient was referred to the endocrinology department with a history of dizziness and fatigue. Past medical history identified that he had been diagnosed with congenital adrenal hyperplasia, presumed to be secondary to 21-hydroxylase deficiency, by 18 months of age whilst living abroad. He had been raised as a male but was found to have 46XX genotype with grade 5 virilisation. During childhood and early adolescence, he underwent multiple operations to remove Mu...

Primary hyperparathyroidism (PHPT) is not uncommon. It has varied presentations ranging from asymptomatic disease to the classical ‘stones, groans, and moans’. The incidence and prevalence of frank diabetes mellitus (DM) is significantly increased in patients with hypercalcaemia. It may be difficult to differentiate symptoms of hypercalcaemia from DM. We present a case of improved glycaemia in a patient with DM following removal of parathyroid adenoma.<p class="a...

A 34-year-old lady with previous renal stones, constipation and well controlled bipolar mood disorder, on lithium for 13 years, was referred with a high calcium of 2.75 mmol/l (normal range: 2.10–2.58 mmol/l) and raised parathyroid hormone of 9.1 pmol/l (normal range: 1.1–4.2 pmol/l). Urine calcium excretion and TFT were normal.The biochemistry was consistent with primary hyperparathyroidism. A workup for possible underlying MEN syndrome came b...

Objective: To describe a postmenopausal lady with hirsutism secondary to a rare leydig cell tumour of the ovary.Case history: A 55 year lady who attained menopause at the age of 49 was referred to us by GP for facial hirsutism of 5 years duration. She was bothered by recent excess hair growth of 4 months duration on the face and arms. She had no other virilising symptoms.On examination, she appeared cushingoid, had a BMI of 31, had...

We report a case of hyperparathyroid crisis presenting with bradycardia (junctional rhythm) in a 65 years old ex nurse with manifestations of hypercalcemia of more than 10 years duration. She presented with palpitation, feeling light headed and not being herself for a day. She found her pulse to be 30/min, which triggered her admission to the accident and emergency department. She was not in any medication to cause hypercalcemia. On examination, she was dry and her thyroid was...

Background: Graves’ disease and Hashimoto’s thyroiditis are the most common autoimmune thyroid conditions. Hyperthyroidism following hypothyroidism is a rare phenomenon. Hypothyroidism was once thought to be a permanent state requiring lifelong replacement therapy but we have noted that there are increasing numbers of cases which are against this postulation. We would like to report 3 cases initially diagnosed with hypothyroidism and referred to us following developm...