Endocrine Abstracts

Introduction: Hypercalcemia is uncommon in patients with adrenal insufficiency. It is common in patients with primary hyperparathyroidism and malignancy.Case: This is a case of primary adrenal insufficiency presenting as acute kidney injury and hypercalcemia. The patient was referred with 10 days history of vomiting, decreased appetite, lethargy and abdominal pain. A week before admission, she developed pleuritic chest pain worsening with inspiration. He...

Background: Postoperative hypocalcemia is common after extensive thyroid surgery and parathyroid surgery. There are various risk factors, although there is lot of variability.Methods and results: The aim of this project was to examine and improve postoperative monitoring and management of serum calcium at a district general hospital. Process was mapped using a flow chart and was discussed in MDT to identify areas for improvement. Data was then collected ...

Background: Terlipressin is a vasopressin agonist used in acute variceal bleeding due to its effect on vasopressin V1 receptors, causing splanchic vasoconstriction. Although it has good safety profile, it has been shown to act as partial agonist of V2 receptors but its effects on serum sodium concentration can be variable.Case Presentation: 58 year old lady was admitted after banding for variceal bleed found at routine screening. She was started on terli...

BackgroundThere is ample data linking GDM to risk of type 2 diabetes mellitus postpartum, however, development of type 1 diabetes mellitus and presentation with DKA is rare especially few weeks postpartum.CaseA 28 year old female 4 month postpartum was admitted to hospital with rapid weight loss and osmotic symptoms. She did not have any past medical history of note, with history of T2DM in both mother and fa...

Background: Hypercalcemia in patients with advanced chronic liver disease (CLD) without hepatic neoplasia is a rarely reported and poorly understood entity. CLD is usually associated with hypocalcaemia because of hypoalbuminemia. Hypercalcemia on the other hand is extremely rare and needs meticulous ruling out of other causes.Case Report: A 55-year-old male who was admitted with jaundice, weight loss and hypercalcaemia. He had a calcium that peaked at 3....

Background: Lactic acidosis is a common finding in critically ill patients. In patients with poorly controlled diabetes for a prolonged period of time, Glycogenic hepatopathy (GH), can cause lactic acidosis which is a rare condition that develops due to excessive accumulation of glycogen in the hepatocytes.Cases: Two cases with poorly controlled diabetes and glycogenic hepatopathy are presented. First patient was a 28 year old female with 20 year history...

Background: There is limited data on the use of Denosumab for hypercalcaemia in patients with primary hyperparathyroidism (PHPT). We describe a case of severe hypercalcaemia in a critically ill patient with COVID, on a background of mild PHPT prior to hospital admission.Case report: Seventy-seven-year-old gentleman with mild hypercalcaemia dating back to 2019, was referred to endocrinology with hypercalcaemia (adjusted calcium 4.02 mmol/l) and associated...

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: Papilledema and raised intracranial pressure has been reported frequently in patients with hypoparathyroidism but very rarely optic neuritis (1).Clinical case: We report a case of 63-year-old male who presented to ophthalmology with right-sided visual loss and a relative afferent pupillary defect. He was diagnosed with optic neuritis and underwent MRI brain which showed bilateral white matter changes with the possibility of demyelination. He ...