Endocrine Abstracts

Introduction: Calcium sensing receptor (CaSR) plays a role in calciotropic processes by regulating parathyroid hormone secretion and urinary calcium excretion. Activating mutation of the CaSR, with heterozygous gain in function, causes autosomal dominant hypocalcaemia 1 (ADH1), a rare disorder with a prevalence of 3.9 per 100,000. Aggressive treatment to normalise serum calcium causes nephrocalcinosis and hypercalcaemia. We present a case of a 27-year-old female with CaSR muta...

Introduction: This case report explores the intricate relationship between polycythemia and hyperparathyroidism in a 42-year-old male, shedding light on the resolution of polycythemia following surgical intervention for PTH-dependent hypercalcemia. Despite the absence of symptomatic nephrolithiasis or renal failure, the patient’s DXA scan revealed osteoporosis, prompting a deeper investigation into the complex interplay between these two conditions. <p class="abstext"...

Introduction: Silent corticotroph adenomas(SCA) are defined as pituitary adenomas showing positive staining for adrenocorticotrophic hormone in immunohistochemical studies not associated with clinical/laboratory features of hypercortisolaemia. We report a case of SCA in a 61-year-old man, who presented with pituitary apoplexy.Case presentation: Patient presented with persistent diplopia of 3 months duration, associated with severe headache for 1 week. He...

Neuromyelitis Optica (NMO) is a neuro-inflammatory condition usually presenting with optic nerve and spinal cord events, caused by autoimmunity to Aquaporin 4 (AQ4) channels in the central nervous system (CNS). The high density of AQ4 channels in the hypothalamus and area postrema mean that NMO can occasionally present with atypical features. We present a 56-year old South Asian man, who presented with hiccoughs and Syndrome of inappropriate antidiuretic hormone (SIADH ) and w...

Introduction: Coexistence of primary hyperparathyroidism and plasma cell dyscrasias such as multiple myeloma and monoclonal gammopathy of uncertain significance (MGUS) is rare. This can cause diagnostic uncertainty regarding the aetiology and relative contribution of each disorder to hypercalcaemia. We present a series of five individuals with this combination.Case series: All five patients were referred to the endocrine clinic with hypercalcaemia. The s...

Background: Primary aldosteronism (PA) is a common, curable and high-risk subset of hypertension, mandating detection. In all but the most severe cases, learned society guidelines recommend confirmatory testing. Whilst a variety of confirmatory tests exist, data describing their safety are limited. Concerns centre around the potential of some tests to precipitate hypokalaemia or a hypertensive emergency in a patient with PA on sub-optimal anti-hypertensive medication. In this ...

Background: Hyperthyroidism often presents with aberrant liver function. The differential diagnosis of this presentation includes thyrotoxicosis-associated liver dysfunction or antithyroid drug-induced liver dysfunction. We present a case where Propylthiouracil treatment resulted in acute liver failure. Case Presentation: A female patient diagnosed with Grave’s disease in August 2023 initially received carbimazole but discontinued this due to vomiting. S...

Introduction: We report a case of a 72-year-old man who was incidentally discovered to harbour a large right adrenal mass during evaluation for resistant hypertension and subsequently diagnosed with an androstenedione and oestrogen secreting adrenocortical tumour.Case report: A 72-year-old gentleman presented with unilateral gynecomastia which was previously investigated with a mammogram and biopsy (normal) to rule out breast cancer. Two years later, he ...

Introduction: Diabetes mellitus is as a major contributor to disease severity and mortality in patients with Covid-19 infection, as the estimated increase in risk of death in hospitalised patients is 3.5-times (for T1DM) and 2.03-times (for T2DM).This retrospective analysis recruited 35 patients from three London hospitals who presented with diabetic emergencies i.e. diabetic ketoacidosis (DKA), Hyperglycaemic hyperosmolar state( HHS), presence of ketone...