Endocrine Abstracts

Introduction: Clinicians are hopeful for substantial weight loss after surgical intervention for obesity, with the funding decisions relatively easier to achieve in those with diabetes, there is a significant proportion of these patients undergoing procedures. In contrast to most outpatient encounters, a 20 kg drop in weight is looked upon favourably between follow-ups where it would have risen the spectre of pathology elsewhere. We present the following case that illustrates ...

A 45-year-old female presented with recurrent episodes of neuroglycopaenic symptoms 6 years after Roux-en-Y gastric bypass surgery. Her symptoms occurred during both the fasting and postprandial state. She had a history of Rheumatoid Arthritis. Her symptoms did not response to a complex carbohydrate diet or Acarbose use.Whipple’s triad was demonstrated during a 72 h fast; symptomatic hypoglycaemia (1.8 mmol/l) occurred which resolved with glucose ad...

Case history: A 73-year-old gentleman was admitted for evaluation of recurrent hypoglycaemia. He has had type 1 diabetes mellitus for 60 years, which was well controlled on a basal-bolus regime with carbohydrate counting. He had frequent hypoglycaemic episodes for 5 months despite drastic reduction in insulin dosage. His insulin was completely stopped on admission. He did not develop ketosis and continued to have hypoglycaemia. He did not have end-organ complications from T1DM...

Case history: A 41-year-old lady referred to diabetes clinic due to chronic diarrhoea on Metformin and for consideration of any injectable treatment. HbA1c was 41 and BMI is 35. In 2007, OGTT during pregnancy showed fasting glucose of 4.1 mmol/l and 2 h glucose of 7.8 mmol/l. In 2013 her fasting glucose was 7.5 and HbA1c was elevated at 53 mmol/mol. Since July 2013 she has been diagnosed as type 2 DM and started on Metformin. In October 2013 HbA1c fell to 49. Over the succeedi...

Background: Hypercalcaemia can occur in 20–30% of malignancy. Neuroendocrine malignancy-related hypercalcaemia is relatively rare with few reported cases, mostly in pancreatic neuroendocrine tumours. It could be related to humoral hypercalcaemia of malignancy (PTHrP secretion), production of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) by the tumour or production of PTH by the tumour1,2. Here we describe a case of metastatic neuroendocrine tumour with pos...

We presenting a case of 26 old lady who is known to have Denys-Drash syndrome, epilepsy and bronchial asthma who presented with history of recent significant weight gain, extensive abdominal bruising and significant muscle weakness which she described literally as not able to use her upper limbs to move to help shuffle her bottom in the floor, a manoeuvre that she was able to do before. Patient is on Carbamazepine, sodium valporate, levetiracetam , salbutamol and Pulmicort inh...

Case: A 44-year-old patient presented with symptoms of sweating, shaking and hunger, which were all eased by eating. Her symptoms were suggestive of hypoglycaemia, experienced predominantly 2-3 hours after meals. Hypoglycaemia was confirmed during these episodes. She had normal liver and renal function. There was no history of Diabetes Mellitus.Her symptoms improved slightly with measures of adjusting her diet but did not sett...

Case: A 44-year-old patient presented with symptoms of sweating, shaking and hunger, which were all eased by eating. Her symptoms were suggestive of hypoglycaemia, experienced predominantly 2-3 hours after meals. Hypoglycaemia was confirmed during these episodes. She had normal liver and renal function. There was no history of Diabetes Mellitus.Her symptoms improved slightly with measures of adjusting her diet but did not sett...

Background: Paragangliomas are extremely rare endocrine tumours and can cause diagnostic difficulty, especially with a coexistent metastatic malignancy.Case: A 78-year-old man with diagnosed metastatic melanoma underwent a PET scan for staging of the malignancy. It showed a left upper quadrant mass with multiple skeletal deposits and a lesion in the pituitary all with intense focal uptake. The mass was unusual for a metastatic lesion from melanoma althou...

We present the case of a 57 year old male that presented to a tertiary centre with a week’s history of lethargy, muscle cramps and peri-oral paraesthesia. He was otherwise fit and well. His examination revealed no evidence of Chvostek’s, Trousseau’s or tetany. His reflexes were not assessed. Initial electrolyte screening confirmed a hypocalcaemia with a serum adjusted calcium of 1.47 mmol/l (2.2–2.6), his phosphate was elevated at 1.64 mmol/l (0.8–1.5)...