Endocrine Abstracts

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...

Case history: A 37-year-old female presented to her GP with myalgia, lethargy and weight gain. Of note she was 24 months post-partum and had not experienced thyroid problems in either of her two pregnancies. On examination she was overweight with marked myxoedema and proximal myopathy.Investigations: Serum TSH was greatly elevated at 206 mIU/l and free T4 was undetectable at <3.20 pmol/l. T3 was 2.8 pmol/l. She was referred urgently to the medical te...

Case history: A 35-year-old female was found to be significantly hypertensive (181/91 mmHg) following a first trimester miscarriage (at 8 weeks gestation) during her first pregnancy.Investigations: Blood tests demonstrated moderate hypokalaemia (2.6 mmol/l) with a normal serum sodium (140 mmol/l) and eGFR (>90 ml/min). ECG showed hypokalaemic changes with prolongation of the PR interval and T wave flattening. To avoid potential misinterpretation, add...

Case history: A 34-year-old man attended the emergency department with a history of sudden onset severe headache associated with vomiting, neck stiffness mild photophobia not relieved with analgesia. He reported a past medical history of hypertension treated with angiotensin-converting enzyme inhibitor (ACEi). There was no focal neurology, and his observations were unremarkable - blood pressure 121/64 mmHg, heart rate 54 beats per minute, respiratory rate 14 breaths per minute...

Hypoparathyroidism following parathyroidectomy is commonly treated with activated vitamin D, (alfacalcidol and calcitriol). Alfacalcidol (1-hydroxyvitamin D) is converted by hepatic 25-hydroxylase to generate calcitriol (1,25-dihydroxyvitamin D) to act on target cells.We present the case of 66 year old man who was admitted with chest pain in November 2016 and found to have corrected calcium of 1.5 mmol/litre and PO4 2.7 mmol/litre....

Hypoparathyroidism following parathyroidectomy is commonly treated with activated vitamin D, (alfacalcidol and calcitriol). Alfacalcidol (1-hydroxyvitamin D) is converted by hepatic 25-hydroxylase to generate calcitriol (1,25-dihydroxyvitamin D) to act on target cells.We present the case of 66 year old man who was admitted with chest pain in November 2016 and found to have corrected calcium of 1.5 mmol/litre and PO4 2.7 mmol/litre....

: We present a case of 79 year old lady who presented to hospital with symptoms of polyuria and polydipsia requiring admission for level 3 care. She reported no bowel symptoms or alcohol usage. Her past medical history showed that she suffered from T2DM, Epilepsy, Asthma, Hypertension and Chronic Kidney disease. Her biochemistry revealed a combination of Hyperglycaemia, Hypokalaemia, Hypomagnesemia, Hypophosphatemia, Hyponatremia and Hypocalcaemia. Her medications revealed no ...

The combination of hypophosphataemia and hypercalcaemia has numerous aetiologies, which can be challenging in the clinical setting. Careful early biochemical identification will facilitate appropriate further imaging and management. We report a case of a gentleman who presented in his ninth decade with deteriorating cognition, proximal muscle weakness and reduced mobility on a background of hypertension, type 2 diabetes with associated ...

The combination of hypophosphataemia and hypercalcaemia has numerous aetiologies, which can be challenging in the clinical setting. Careful early biochemical identification will facilitate appropriate further imaging and management. We report a case of a gentleman who presented in his ninth decade with deteriorating cognition, proximal muscle weakness and reduced mobility on a background of hypertension, type 2 diabetes with associated ...

Amiodarone-induced thyroiditis (AIT) can be a diagnostic and therapeutic challenge. It can be a diagnostic challenge in clinical cases, where response to therapy can be slow. It is important to achieve an early differentiation between various subtypes (i.e. AIT type 1 or AIT type 2) to guide therapy. We present a case of a 51-year-old man with a history of paroxysmal atrial fibrillation for which he was treated with a maintenance dose of Amiodarone. He presented ...