Endocrine Abstracts

Hyperprolactinemia is known to have a wide differential with multiple causes including physiological, pathological and pharmacological. Drug induced causes of hyperprolactinemia are myriad however these become significant when prolactin levels rise to proportions that lead to clinical manifestations. We present a case of a 40 years old lady who was referred to endocrinology for an irregular menstrual cycle. Initial investigations revealed a prolactin level of 5767 mIU/l (range...

We present an interesting case of Heparin inducedhypoaldosteronism associated hyperkalemia in a 69 year old man with a prosthetic heart valve requiring a right sided nephrectomy for a liposarcoma. His persistent hyperkalaemia failed to respond to conventional treatment initiallybut a switch to Warfarin and use of oral Fludrocortisone was effective in normalisation of observed high renin and low aldosterone levels. Early and timely recognition of Heparin induced hypoaldosteroni...

Gums inflammation (gingivitis) if not treated on time and permitted to grow, ends into periodontitis in which alveolar bone that supports teeth is invaded and destroyed. Juvenile periodontitis is a genetic disorder and can occur without plaque and calculus. It is a disease of people below 30 years of age.Subjects and methods: This cross sectional study involved a total of 160 subjects including 80 chronic periodontitis patients and 80 healthy controls be...

A 67-year-old woman was diagnosed by her GP with hypothyroidism and referred to our department. During the first 2 years after diagnosis, the TSH remained elevated (16–19 mlU/l) with the free T4 ranging 11.1–31.9 pmol/l despite her insistence that compliance with therapy was good and on incremental doses of thyroxine. When seen in the nurse-led thyroid clinic for the first time, concerns were raised to the consultant endocrinologist. Interference with the TSH assay w...

A 54 yr old man presented with a six-month history of palpitations, sweating and weight loss. He had a past history of hypertension, type II diabetes, asthma and was HIV-1 seropositive since 14 yrs and was taking potent anti-retroviral therapy: Nevirapine 200 mg bd; Kaletra 3 capsules bd; and didanosine ec 400 mg od.Investigations confirmed Graves thyrotoxicosis (fT4 72.1 pmol/l; TSH <0.01 mU/l; and TSH receptor antibody positive). He was initially t...

Traditional literature has dictated diabetes to be a chronic irreversible disease with progression of micro and macrovascular complications. Modern medicine has now started to include bariatric surgery, starch restriction as potential interventions which could control diabetes at initial stages. Our case report is unique as it illustrates patient directed reversal of diabetes with lifestyle intervention. 77 years old gentleman was diagnosed with Type 2 diabetes at the age of 5...

Glycogen storage disease, which is a metabolic disorderof glycogen storage, affecting 1 in 20000-40000 ive births. This is a case of yound adolescent female with glycogen storage disease type1b, presented with lactic acidosis and managed in ITU.18 years old femae from Honk kong, student in a college, admitted to a dgh hospital with fever, vomiting and abdominal pain for a week. examination showed severe features of dehydratio...

Glycogen storage disease, which is a metabolic disorderof glycogen storage, affecting 1 in 20000-40000 ive births. This is a case of yound adolescent female with glycogen storage disease type1b, presented with lactic acidosis and managed in ITU.18 years old femae from Honk kong, student in a college, admitted to a dgh hospital with fever, vomiting and abdominal pain for a week. examination showed severe features of dehydratio...

The majority of clinically palpable masses affecting the thyroid are benign. Malignant thyroid tumours are the commonest endocrine malignancies yet are rare. Most are of a single distinct cellular type, though mixed cellularity tumours also occur, the commonest of which is papillary and follicular. We describe 2 cases with more than one differentiated tumour in each thyroid gland.CASE 1A 44y builder with a family history of medulla...

A 27y old woman presented with a 2yr history of secondary amenorrhoea and mild hyperprolactinaemia. CT scan demonstrated an enlarged pituitary gland abutting the optic chiasm. Goldman perimetery was normal and trans-sphenoidal hypophysectomy undertaken. Post-operatively she suffered temporary diabetes insipidus responding well to desmopressin. At endocrine assessment, she was growth hormone deficient, had partial diabetes insipidus and a sub-optimal cortisol response. Desmopre...