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...

Introduction: More than 95% of cases of Acromegaly are caused by pituitary adenomas that present with insidious onset of symptoms due to local mass effects or due to excess of GH/IGF-1. It is often diagnosed late and results in high morbidity and mortality.Case: We present a case of a woman in her fifties with atypical presentation of acromegaly with a left sided headache for 2 years with no associated visual symptoms an...

Introduction: Secondary hypothyroidism can be a difficult diagnosis to make in patients presenting with fatigue. About 30% of females can develop hypopituitarism post-partum and report symptoms after losing any of the anterior pituitary hormone axis. Central hypopituitarism can occur secondary to various structural and vascular abnormalities but can present with pure hormonal abnormalities.Case: We present a case of a wo...

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: 26 year old man with uncontrolled hypertension and weight gain over the last 10 – 15 years associated with abdominal stretch marks. His past medical history includes hypertension managed with four oral anti-hypertensive agents and a BMI of 36.74 kgm2 (with centripetal obesity). There is no family history of hypertension.Investigations: However, there was historical biochemical evidence of hypokalaemia (between 2.6 – 3.2mmol/l) in ...

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...

Here we present two interesting cases of pheochromocytoma with unusual presentation. Case1: A 61-year-old gentleman presented with syncope after noticing small amount of haematuria. His initial working diagnosis was vasovagal syncope but on further exploration, he reported previous history of palpitations and atypical chest pain. He was non-smoker with longstanding hypertension. His CT(urogram) showed incidental left adrenal nodule after...

The COVID-19 vaccine plays an important role in managing the pandemic. Unfortunately, there are endocrine side effects also noted. The 36-year-old lady felt unwell 2 weeks post-AstraZeneca COVID-19 vaccine. She got admitted to the hospital after 6weeks with persistent vomiting and significant hyponatremia. She has a past history of well-controlled asthma and hypothyroidism. Random cortisol on admission was 31 nmol/l, and a short synacthen test(SST) confirmed adrenal insufficie...

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....