Endocrine Abstracts

Aldosterone is a steroidal hormone that specifically binds to the mineralocorticoid receptor (MR). Production and secretion of aldosterone is triggered by changes in blood pressure (BP). Primary aldosteronism (PA) is an important cause of secondary hypertension. The effects of aldosterone have been described in renal and vascular tissue but recent studies have shown that MR is also expressed in non- epithelial cells such as those of the immune system. A 29-year-old Afro-Carrib...

Case history: A 33 year old gentleman presented with a 4 month history of an evolving rash. This initially appeared on the extensor surfaces of the knees bilaterally and progressed to involve both arms and the trunk. This rash was not associated with fever, pain, pruritis or any other symptoms. These lesions were diffuse erythematous crops of yellow papules visible over the knees, arms and trunk. The patient was initially diagnosed with folliculitis and treated with oral flucl...

Case history: We present the case of a 64 year old man with an incidental finding of pituitary macroadenoma (1.1×0.8×0.5 mm). He had a past medical history of obstructive sleep apnoea, asthma, osteoarthritis, hypertension, retinal detachment and cataract.Investigations: Blood tests.Results and treatment: Pituitary function tests showed markedly elevated prolactin 4272 mIU/L (86–324), elevated free tri-iodothyronine (...

Case history: We present the case of a 51-year-old female of South-East Asian origin presenting with a four-day history of feeling progressively unwell with vomiting, reduced oral intake and urinary symptoms. Her past medical history was T2D (HbA1c 98 mmol/mol March 2018). Drug history on admission was Metformin 500 mg twice daily, Gliclazide 160 mg twice daily, Ramipril 1.25 mg once daily and Dapagliflozin 10 mg once daily. The initiation date of Dapagliflozin and Ramipril co...

Case history: Case 1: 18-year-old female referred with asymptomatic hypercalcaemia (adjusted calcium 2.69 mmol/l), phosphate 0.96 mmol/l, parathyroid hormone 2.6 pmol/l and total 25 hydroxyvitamin D 37 nmol/l. No evidence of end organ damage. Initial calcium: creatinine clearance ratio 0.0033 but the patient had a vitamin D 24 nmol/l. Case 2: A 53-year-old female referred with asymptomatic incidental hypercalcaemia (adjusted calcium 2.73–2.87 mmol/l), raised parathyroid h...

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...

During starvation, ketone bodies acetoacetate and 3-D-hydroxybutyrate are freely soluble energy substrates made by the liver. Their major role is to supply an alternative glucose substrate for the brain under conditions of medium- and long-term energy restriction. The most common cause of pathological ketoacidosis is poorly controlled type 1 diabetic mellitus triggering uncontrolled hyperglycaemia. Other common causes are alcoholic ketoacidosis and fasting ketosis. In non-diab...

Effective management of obesity is increasingly challenging with the continued growth of the nation’s waistlines and bariatric surgery is not the always the answer to this problem. The synergistic action of GLP-1 agonists (GLP1A) and SGLT2 inhibitors (SGLT2I) represents a possible therapeutic approach for patients with Type 2 diabetes (T2DM) and obesity in whom bariatric surgery has been ineffective or is not possible. A single centre retrospective study was performed to ...

A 49-year-old female was admitted to with diabetic ketoacidosis (DKA) and newly diagnosed diabetes. Her only significant medical problem was malignant hypertension with poorly controlled blood pressure (BP) on four antihypertensive agents. She reported no exogenous glucocorticoid or liquorice ingestion. She also complained of a 6-month history of lethargy, weight gain, and a two-month history of easy bruising, lower-limb weakness, increasing polyuria and polydipsia. There was ...

Hyperglycaemic hyperosmolar state (HHS) is a common medical presentation, typically occurring in older patients with Type 2 diabetes mellitus. Mortality rates have been reported to be up to 60%. Precipitating factors include dehydration, sepsis, cardiovascular disease and drugs. Here, we describe a rare case of HHS, likely to have been precipitated following the development of lithium-induced nephrogenic diabetes insipidus (DI).A 62-year-old female prese...