Endocrine Abstracts

A 74 year old lady presently to casualty with generalized ill health, vomiting and a mechanical fall. She was well known to the psychiatry team with severe depressive disorder managed with Lithium. Clinical examination was unremarkable. Baseline blood tests confirmed hyperparathyroidism with corrected calcium of 3.24 mmol/l and high parathyroid hormone levels of 13.4 pmol/L. Lithium levels were normal. She improved clinically with intravenous hydration followed by pamidronate ...

A 68 years old lady was referred to our endocrine clinic after she had routine blood tests done as a part of monitoring of her chronic kidney disease stage 3. She had high corrected calcium of 2.85 mmol/l and parathyroid hormone levels of 13 pmol/l consistent with primary hyperparathyroidism. She was clinically symptomatic with high calcium and had polyuria, polydipsia and constipation. There was no history of renal calculi or fractures although DEXA scan confirmed osteoporosi...

Introduction: We report a patient with hypercalcaemia secondary to parathyroid hormone related peptide (PTHrp) from metastatic oesophageal cancer and co-existing primary hyperparathyroidism.Case report: A 52-year-old lady was admitted to the hospital with a 2-week history of right scapula pain, reduced appetite and weight loss.Blood test revealed an adjusted calcium of 3.99 nmol/l (NR 2.1–2.55 nmol/l), PTH of 147 ng/l (NR 15&#...

We present two thyroid antibody positive euthyroid women with history of recurrent miscarriage who had successful pregnancy outcome when treated with levothyroxine.A 31-year-old Caucasian lady was referred to our endocrine services with a history of three previous miscarriages. She had strongly positive thyroid peroxidise antibodies (TPO) with normal thyroid function tests.We commenced her on 25 μg of levothyroxine. Within two...

We report a 41 yr old man who was found dead in his bed with a continuous glucose monitoring device in situ. He had type 1 diabetes diagnosed at age 14 years. He had poor glycaemic control during his teenage years and suffered from severe hypoglycaemic episodes and reduced hypoglycaemic awareness resulting in three road traffic accidents. His diabetes was complicated by proliferative retinopathy, nephropathy and peripheral neuropathy. He began continuous subcutaneous insulin p...

A 38 year lady was referred with a five month history of secondary amenorrhea, galactorrhoea, failure to conceive and elevated prolactin levels of 2023 miu/L (reference 102–496 miu/L). She could not undertake an MRI scan of the pituitary gland as she was claustrophobic and hence a CT scan was performed which did not show and gross pituitary lesion. Microprolactinoma was diagnosed and she commenced bromocriptine. She had normal white blood cells and neutrophil count prior ...

Introduction: Obstructive sleep apnoea (OSA) is common and frequently found in patients with obesity and type 2 diabetes mellitus. This case report shows the infrequently documented link between OSA and type 1 diabetes and highlights the need to confirm the type of diabetes especially in complex and atypical cases.Case report: A 44-year-old gentleman, with a BMI of 34, was diagnosed with type 2 diabetes and was treated with metformin and given lifestyle ...

Background: Poor adherence with thyroxine treatment is a common problem faced by endocrinologists the world over. Abnormally elevated TSH levels, with rising levels of treatment is an ongoing management challenge, especially with patient insistence of compliance. There are a number of investigative tools advocated. We present a case managed through an observed thyroxine absorption test.Methods: A 36-year-old woman was referred by her primary care practit...