Endocrine Abstracts

Background: Refractory hypothyroidism poses a clinical dilemma, with great difficulty to treat. Novel cases have targeted intramuscular (IM) levothyroxine (LT4) as a potential treatment for cases resistant to oral LT4. We discuss a patient who became intolerant of IM LT4 after 18 years of treatment, thus SC LT4 was initiated as alternative management.Case Presentation: 35-year-old female with diagnosed Schmidt’s Syn...

Background: Vitamin D is important for calcium homeostasis. In granulomatous diseases including tuberculosis (TB), hypercalcaemia may be seen. Suspected mechanisms include elevated vitamin D sensitivity and increased extrarenal synthesis of 1,25-dihydroxyvitamin D [1,25(OH)2D] by alveolar macrophages within granulomas. Prevalence of hypercalcaemia in TB patients vary worldwide, yet is rare in the UK. We present a case of hypercalcaemia in a patient with TB reactivat...

Background: Pituitary metastasis (PM) is a rare occurrence in malignancy, associated with poor prognosis. Only 7% of patients are symptomatic. High index of suspicion and prompt investigation are essential. We report a case of PM, highlighting challenges in diagnosis and management.Case Report: Sixty-six year old male was referred to endocrinology due to headaches and hyponatremia. He had metastatic colorectal carcinoma, treated with bowel, liver and lun...

Background: Ectopic Cushing’s syndrome (ECS) is a rare and severe condition at times presenting acutely with intense hypercortisolism. The intensity of hypercortisolism can be disproportionate to underlying tumoral condition, and associated life-threatening complications are common arising suddenly. Hypercortisolism must be controlled rapidly pending definitive treatment of tumoral source to avoid life-threatening consequences.Case Summary: 31-year-...

Background: Pituitary metastasis (PM) is a rare occurrence in malignancy, associated with poor prognosis. Only 7% of patients are symptomatic. High index of suspicion and prompt investigation are essential. We report a case of PM, highlighting challenges in diagnosis and management.Case Report: Sixty-six year old male was referred to endocrinology due to headaches and hyponatremia. He had metastatic colorectal carcinoma, treated with bowel, liver and lun...