Endocrine Abstracts

Familial hypocalciuric hypercalcaemia (FHH) usually manifests with mild asymptomatic hypercalcaemia. Presentations with severe hypercalcaemia are uncommon and may be mistakenly assumed to be primary hyperparathyroidism (PHPT) unless detailed testing is undertaken on all cases of hypercalcaemia. We present 4 cases of FHH presenting with severe hypercalcalcaemia, corrected serum calcium (coCalcium) > 3 mmol/l. Three cases were initially admitted to hospital as medical emergencie...

Hypercalcaemia is a recognised feature of hyperthyroidism due to accelerated bone turnover caused by thyroid hormone. When present, it is generally mild, usually with levels < 3.00 mmol/l. We present a case of a 19 year old male with thyrotoxicosis, who had severe hypercalcaemia and was also found to have possible co-existent adrenal insufficiency at the same time.He presented with a 4 month history of weight loss, anxiety, tremors and palpitations. ...

Current guidance recommends replacing vitamin D in patients with mild primary hyperparathyroidism although there are reports of worsening hypercalcaemia in some patients. Vitamin D replacement has also been known to cause hypercalcaemia in patients with sarcoidosis. We present a case of a patient with co-existent sarcoidosis and primary hyperparathyroidism, who developed severe hypercalcaemia following treatment with high dose Vitamin D.A 63 year old lad...

Addison’s disease rarely newly presents during pregnancy. We highlight two cases diagnosed within 3 months. A 41-year-old with mild depression on Sertraline, presented at 11-weeks’ gestation with an 8-week history of fatigue, weight loss, dizziness and vomiting. Persistent hyponatraemia was noted (Na 122–127 mmol/l). Random cortisols were 298–428 nmol/l. Sertraline withdrawal and fluid restriction at another centre did not improve her hyponatraemia, the use...

Opiate use is a well-recognised cause of hypogonadotrophic hypogonadism. Adrenocorticotrophic hormone and growth hormone deficiencies are much rarer.A 56-year-old female presented with weight loss, lethargy, and nausea of ~3 years duration. She had received treatment with morphine sulphate 100 mg twice daily for ~15 years for back pain due to disc prolapse and osteoarthritis. A 0900 h cortisol of 110 nmol/l requested by her general practitioner had resul...

Immobilisation is a recognised but rare cause of hypercalcaemia. Most reported cases are patients with spinal cord injury or trauma.Case 1: A 26-year-old female experienced a 5½ months admission to the intensive care unit (ITU) with complications following small bowel resection for Crohn’s disease. At 16 weeks she developed hypercalcaemia. Investigations confirmed calcium 3.24 mmol/l, parathyroid hormone (PTH) <0.6 pmol/l (1.6–6.9), 24...

Cushing’s syndrome is a rare disease with an incidence of 0.72–2.4/million per year. Approximately 14% of patients are over 60 years of age but <1% are over 80 years of age. In a 2-month period, we diagnosed three females over 80 years of age as having Cushing’s syndrome. None of them had a typical cushingoid appearance.Patient 1, 80 years of age. Presentation: coincidental finding of bilateral adrenal hypertrophy on CT scanning as par...