Endocrine Abstracts

Case history: A 39 year old female presented reporting a 5-year history of swollen face, hands and feet, with associated joint pain. She was initially investigated for rheumatoid arthritis. She had no significant past medical history except for a previous miscarriage in 2014 and treatment for hypertension in a subsequent successful pregnancy. Post-partum she breastfed with no difficulty for 18-months but remained amenorrhoeic during this time. During 2016 she noticed increase ...

As the SGLT-2i class gains popularity for management of type 2 diabetes (T2DM), the risk of diabetic ketoacidosis (DKA) has been recognised as a potential adverse event. However, all the reported cases of DKA associated with SGLT-2 inhibitors seem to have some additional predisposition to this condition and been exposed to alternative precipitants. We report a root-cause analysis of five locally presenting cases of DKA associated with dapagliflozin followed by a literature rev...

Thyrotoxic period paralysis is a rare endocrine emergency associated with hyperthyroidism that needs urgent treatment. We present a case of a 19-year-old Chinese student who was admitted with progressive weakness in his lower limbs developing overnight. He was resident at the students’ hostel and went to sleep after ignoring mild leg weakness overnight but could not even get up from his bed in the morning. Luckily his friend called the ambulance and brought him in hospita...

Hashimoto’s encephalopathy (HE) is a very rare neuropsychiatric condition associated with autoimmune thyroid disorders which shows a remarkable response to steroid therapy and hence is also called steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT). We report a case of 44 year old lady presenting twice with psycho-affective symptoms but not receiving the diagnosis on first presentation. She initially presented with 3 wee...

: A family with generalised resistance to thyroid hormone secondary to a missense point mutation in thyroid hormone receptor β (TR-β) gene corresponding to substitution of arginine to histidine at amino acid 438 (R438H) is described in three successive generations.Case 1: (Index case) A 43 year old lady presented with thyrotoxicosis and was initially treated with carbimazole followed by radio-iodine ablation of the thyroid. Thyroxine was commen...

We report a case of 43 year old gentleman who had surgery in 1998 for left glomus typanicum, leaving him with complete left lower facial nerve palsy. Incidentally he was noted to have had labile blood pressure during this surgery. He had gradual growth of residual tumour which required fractionated radiotherapy in 2012. He has had ongoing problems with headaches with profuse left-sided rhinorrhoea and intermittent episodes of sweating. In...

We report a case of 43 year old gentleman who had surgery in 1998 for left glomus typanicum, leaving him with complete left lower facial nerve palsy. Incidentally he was noted to have had labile blood pressure during this surgery. He had gradual growth of residual tumour which required fractionated radiotherapy in 2012. He has had ongoing problems with headaches with profuse left-sided rhinorrhoea and intermittent episodes of sweating. In...

We present a case of 71-year-old gentleman who presented with bitemporal hemianopia in 2008 with pituitary apoplexy compressing the optic chiasm. Prolactin was 55287MU/l, with deficiency of all other anterior pituitary hormones. He underwent transphenoidal adenectomy (TSA). Prolactin was 35633MU/l post-operatively and cabergoline was commenced. Histology was consistent with a lactotroph adenoma with MiB-1 index of 3–5%. Visual fields recovered and prolactin was normal unt...