Endocrine Abstracts

Traditional literature agrees that Diabetic Ketoacidosis is typically associated with Type 1 Diabetes Mellitus, but can be associated with stress including infections in Type 2 diabetics. The authors did a restrospective evaluation of diabetic ketoacidosis presenting to a large district hospital in London. 343 patients were admitted with diagnosis of Diabetic Ketoacidosis during the COVID peaks from January 2020 to January 2021. 57% of these were Type 1 diabetics and 43% were ...

Disorders of sodium metabolism in sarcoidosis are predominated by diabetes insipidus; SIADH is extremely rare, restricted to sporadic case reports. We present the case of a 68 year old South Asian female presenting with a 3 year history of chronic, mild hyponatraemia, which was asymptomatic apart from mild lightheadedness. She had a history of stable sarcoidosis that was not requiring treatment, based on lung pathology. Despite fluid restriction, serum sodium remained around 1...

The association between hypomagnesaemia and proton pump inhibitors (PPIs) has been well-established in recent years, with a median onset of electrolyte disturbance around 5.5 years after PPI initiation. The mechanisms and aetiology of this potentially life-threatening side-effect remain unclear. We assessed the prevalence of PPI usage in all cases of severe hypomagnesaemia (defined for the purposes of the study as a magnesium level <0.4 mmol/l) in our hospital over the cou...

Prolactinomas are the most common functional pituitary tumours. Therapy is with dopamine agonists (DA). Cabergoline is frequently used as a first line agent; resistance to therapy is seen to other DA. We present a case of a 32 year old woman who moved to our area in the 1st trimester of pregnancy. She was known to have macroprolactinoma (maximal diameter > 1 cm), impinging on the optic chiasm. She was on cabergoline 0.5 mg once daily, but this was discontinued with no complica...

Background: Immune checkpoint inhibitors are now commonly used in melanoma, renal cell carcinoma and non-small cell lung cancers. Patients on immune check point inhibitors experience at least one type of immune related adverse event(irAEs) which can occur even after discontinuation of therapy. Endocrine toxicities are commonly reported irAE′s and tend to be irreversible. The most frequently recognized endocrine complications include thyroid dysfunction (30%) hypophysitis...

64 years old lady with history of breast cancer (post lumpectomy followed by radical mastectomy) received chemotherapy with Epirvlacin 140 mg and cyclophosphamide 600 mg 1 day prior. Past medical history included hypertension on ramipril and type 2 diabetes on diet control. Bloods on day of chemotherapy normal particularly sodium 135 mmols/l. Presented in 18 hours after 20 seconds tonic clonic seizure noted by family followed by abnormal flexion. Presented with GCS 7 which the...

A 49-year-old female was admitted to medical HDU with diabetes ketoacidosis (DKA) and newly diagnosed diabetes. Six months previously she was diagnosed with malignant hypertension. She had poorly controlled blood pressure despite treatment with four anti-hypertensives, which were her only regular medication. She had never used any medications or creams containing glucocorticoids. She had no history of hypokalaemia and reported no use of liquorice. She recently attended an outp...

Introduction: Primary hyperparathyroidism (PHPT) is an endocrine condition in which autonomous excessive secretion of parathyroid hormone (PTH) results in hypercalcaemia. In approximately 80% of cases the aetiology is due to a single parathyroid adenoma, the remainder are due to hyperplasia of more than one gland. Familial Hypocalciuric Hypercalcaemia (FHH) is an autosomal dominant, inactivating mutation of the calcium-sensing receptor, causing a right-shift in the concentrati...

63 years old with sarcoidosis since 2018 and type 2 diabetes was referred by GP for hypercalcemia related to likely dehydration and sarcoidosis. She was started on a weaning dose of prednisolone and empagliflozin. She had already been on metformin for several years. She was discharged after calcium improved from 2.97 mmol/l to 2.83 mmol/l. She was advised to follow up in Ambulatory care in 1 week for repeat calcium levels. On follow up, noted to have calcium levels of 2.67 mmo...

45 years old male of Romanian origin presented with shortness of breath and reduced exercise tolerance over 3 months with increased sweating and weight gain from 90 kgs to 118 kgs over 2 years. Also reported hands/fingers/feet size increase. He also complained that his breathlessness worse by as tongue and lips were ‘large’. Denied any visual disturbance, especially peripheral vision. On examination, coarse features, prognathism and possible macroglossia noted. Photo...