Endocrine Abstracts

Background: To identify areas of improvement in the management of Type 1 Diabetes Mellitus patients by analysing their clinical data.Methods: Computer records of 333 T1DM patients on follow-up at Tan Tock Seng Hospital from May to October 2017 were reviewed and analysed retrospectively.Results: The average age of diagnosis is 29.75 years-old, and average BMI was 22.59 kg/m2. 18% of patients had concomitant thyroid diseas...

Background: Papillary thyroid carcinoma (PTC) in patients with background Graves’ disease (GD) has been associated with a higher risk of post-operative tumour recurrence. We present a case and review the literature for possible explanations.Case presentation: A 55-year-old gentleman with GD treated with carbimazole presented 1 year after initial diagnosis with a 3 cm palpable thyroid nodule. Fine needle aspiration cytology (FNAC) was suggestive for ...

Introduction: Primary hyperparathyroidism (PHPT) is usually caused by a single hyperfunctioning parathyroid adenoma. Preoperative localization studies allow for minimally invasive surgical removal. We present a case of PHPT caused by a solitary adenoma that could not be localised pre-operatively and review existing and emerging localisation modalities.Case report: A 65-year-old Chinese lady admitted for neck of femur fracture was found to have hypercalca...

Background: Many drugs are known to cause thyroid dysfunction. We describe a patient with hypothyroidism due to isotretinoin.Case: A 28 year-old Chinese gentleman presented with 2-year history of fatigue and cold intolerance. He has acne vulgaris and has been taking isotretinoin for the last 3 years (20 mg daily for 1 year then 10 mg daily). He has a positive family history of thyroid disorders. He did not report any history of thyroiditis or known autoi...

Objective: Agranulocytosis is a rare but severe side effect of thionamide use in patients with hyperthyroidism. Treatment involves cessation of offending drug, treatment of sepsis, and the use of haematopoietic growth factors. Most patients recover uneventfully, and rarely present with further complications after treatment of the acute episode. We present a case report of suppurative lymphadenitis after treatment with granulocyte-stimulating factor (GCSF) and recovery from car...

Background: Primary adrenal insufficiency due to adrenal hemorrhage from anti-phospholipid syndrome (APS) is an uncommon and life threatening disorder. We present a case, highlighting the challenges in the diagnosis and management of this disorder.Case presentation: A 59-year-old Chinese lady presented with a 2-year history of bilateral flank pain, lethargy, poor appetite and weight loss. Initial blood investigations were unremarkable except for a choles...

Introduction: Drug rash with eosinophilia and systemic symptoms (DRESS) is a severe drug eruption with systemic involvement. Visceral manifestations consisting of fulminant hepatic failure, myocarditis, interstitial nephritis, pneumonitis and autoimmune hypothyroidism are known sequela. We report a case of DRESS syndrome post Bactrim (sulfamethoxazole and trimethoprim) therapy complicated by both myocarditis and autoimmune thyrotoxicosis.Case report: A p...

Introduction: We report a patient who presented with presumed intestinal obstruction, and was subsequently diagnosed with an adrenal phaeochromocytoma associated with venous thromboembolism. We review the literature and discuss underlying mechanisms for these uncommon manifestations.Case presentation: A 56-year-old man with background untreated hypertension presented with abdominal distension, vomiting, breathlessness and haemoptysis. Heart rate (HR) was...

Introduction: Adefovir, commonly used for the treatment of hepatitis B, has dose-related nephrotoxicity, especially at doses of 60 mg daily and above. We describe a patient with Fanconi’s syndrome after being on low dose adefovir for more than 5 years.Case report: A 62-year-old Chinese man, a chronic carrier of Hepatitis B on adefovir 10 mg daily for over 5 years, presented with the incidental finding of profound yet asymptomatic hypokalemia (K 1.9 ...

Introduction: Panhypopituitarism is a known but rare presentation of lymphoproliferative disease. We describe a patient with newly diagnosed advanced diffuse large B-cell lymphoma who presented with anterior hypopituitarism and concomitant adrenal gland involvement.Case report: A 72 year-old Chinese woman presented with a few weeks’ duration of lethargy, weight loss and functional decline. A hormonal screen done at admission suggested central hypoth...