Endocrine Abstracts

We present the case of a 49 year old Caucasian lady who was referred for urgent evaluation to rule out Cushing’s syndrome. She had progressive increase in bulk of her shoulders and upper arms over several months. She had a history of asthma, hypertension, and alcohol excess. She had inadvertently been using fostair (steroid inhaler) as a reliever up to 10 times a day. She denied anabolic steroid or drug use. She had no clinical features of Cushing’s syndrome. There w...

A 30-year-old lady was initially seen in our clinic with a slight elevated corrected calcium with an elevated parathyroid hormone in March 2021. The elevated calcium [2.58mmol/l(NR: 2.10-2.55)] was first noted in 2018 when she had investigations for easy bruising, fatigue, breathlessness, and weight loss. The symptoms settled on their own and her calcium levels were monitored routinely. She was referred to our clinic when the corrected calcium had increased to 2.69mmol/lwith a...

Empty sella is an incidental finding characterised by the herniation of subarachnoid space into the sella turcica with resultant flattening of pituitary gland to varying extent. It was considered benign. But recent reviews have shown its association with some neuroendocrinopathies.Aims and Objectives: To determine if patients with radiological diagnosis of PESS were;1. Referred to Endocrinology team?2. What p...

Background: We would like to present a case of pancreatic encephalopathy induced by DKA induced hypertriglyceridemia. The triad of acute pancreatitis, hypertriglyceridemia and diabetes is a rare occurrence. Through our case we aim to highlight the importance of making an early diagnosis as a delay in diagnosis can worsen outcomes.Case history: We present the case of a 51 year old Type 2 Diabetic non compliant with her medications who was admitted to the ...

Background: Primary hyperparathyroidism is the commonest cause of hypercalcemia. Current guidelines advise to rule out familial hypocalciuric hypercalcemia (FHH) when evaluating hypercalcemia. It is widely considered that FHH is associated with low urine calcium creatinine clearance ratio (CCCR). However, low CCCR can also occur in Primary hyperparathyroidism.Case: A 30 years lady presented with hypercalcemia and high parathyroid hormone (PTH). She had a...

Background: Hypothalamus pituitary adrenal axis (HPA) dysfunction is associated with serious morbidity and mortality. Its symptoms can be non-specific. Objective diagnosis depends on clinical suspicion and confirmed on assessment of early morning cortisol or dynamic assessment of cortisol secretion. The cosyntropin or short synacthen test (SST) has emerged as the most common test to assess the HPA. The insulin stimulation test (IST) is the traditional ‘gold standard’...

Background: Myasthenia gravis and thyroid disease can sometimes create diagnostic confusion because the two may have similar clinical features and may also co-exist in the same individual.Case: A 68 years male, was seen in the Neurology clinic with drooping of his left eyelid, first noticed 8 months prior, worse in the evenings. There were no other complaints. He had history of type2 diabetes, and Graves’ disease. On examination, he appeared to have...

Sarcoidosis is a granulomatous multi-systemdisorder of unknown ethology. It has a higher prevalence in Northern Europe and the UK. Neurosarcoidosis is a relatively less common, but serious complication of sarcoidosis. CASE: A 48 year old man presented to the hospital with intermittent fever, and neck pain and stiffness, of six weeksduration. This was associated with excessive tiredness, loss of libido, decreased appetite, and unintentional weight loss of two stone over a perio...

Background: Newer biological drugs such as immune checkpoint inhibitors (ICI) have recently revolutionized cancer therapy. However, hypophysitis and adrenalitis are recognized side-effects of these new therapies. Hypothalamus pituitary adrenal (HPA) axis dysfunction is associated with serious morbidity and mortality. This study aimed to monitor whether the ICI related HPA axis dysfunction recovers.Materials and Methods: We have conducted a retrospective ...

A 28-year-old female presented to ED with one week history of flu-like symptoms, palpitations, increasing breathlessness, and productive cough with copious sputum, of two days duration. There was h/o some weight loss over the last year, with episodic palpitations over the last 8-10 years that increased in frequency over the last one year. She had a family history of hyperthyroidism paternally and maternally. On examination, there was mild lid-lag and proptosis. She was tachypn...