Endocrine Abstracts

Introduction: Hyponatraemia, defined as serum sodium <135 mmol/l is commonest electrolyte abnormality and is frequently encountered in elderly population. It is associated with osteoporosis and falls and an independent risk factor for fractures. The reported 1-year mortality for fracture neck of femur is between 20 and 35%.Aim: To evaluate the impact of hyponatraemia on patients with fracture neck of femur compared to normonatraemia admitted to the h...

Hyponatraemia is the commonest electrolyte disorder in hospitals and frequently encountered in patients with heart failure (HF). Elevated circulating levels of arginine vasopressin AVP correlate with disease severity with higher levels in decompensated HF. The activation of AVP from posterior pituitary is mediated through pressure sensitive baroreceptors by impaired cardiac output resulting in increased passive water reasorption in the kidneys with resultant hyponatraemia. Thi...

Introduction: Central pontine myelinolysis, CPM classically occurs in alcoholics, malnourished and elderly, few days following rapid correction of hyponatraemia resulting in permanent neurological squeal. We described two cases of CPM occurring in alcoholics after 3 weeks of hospital admission with complete recovery of gross neurological signs.Case 1: 24-year-old male, known alcoholic, was admitted with left hemiplegia and features of bulbar and pseudobu...

Hyponatraemia, the commonest electrolyte disorder in hospitals is associated with increased length of stay, morbidity and mortality. The treatment of euvolaemic hyponatraemia with fluid restriction and demecocycline is ineffective. Tolvaptan, a V2 receptor antagonist is licensed for treatment of SIADH, based on two RCT, SALT 1 and SALT 2 studies. The cost of Tolvaptan restricts its use in NHS hospitals with no clear indications with regards to suitable cases. These case report...

Introduction: Hyponatraemia is the commonest electrolyte disorders encountered in hospitals. The aetiology of hyponatraemia is based on clinic assessment and biochemical investigations. However, studies have shown that recommended guidelines are usually not implemented.Aim: Review of assessment (diagnosis) of Hyponatraemia and outcome based on length of stay (LOS) in hospitals.Methods: A systematic search using PUB Med and Med Line...

Familial hypocalciuric hypercalcaemia (FHH) is a benign condition, occurs as a result of inactivating mutation in the calcium sensing receptor (CASR) gene and is autosomal dominant.We present a 56-year-old lady with periodic mild hypercalcaemia since 2004. Her highest corrected calcium concentration was 2.76 mmol/l (NR 2.2–2.6). She was asymptomatic. Her parathyroid hormone concentration was also mildly elevated at 9.7 pmol/l (NR 1.6–6.9). Her ...

Case: A 73-year-old Pakistani gentleman with known hypertension and type two diabetes mellitus initially presented to hospital hypotensive, with epigastric pain and vomiting. An abdominal CT confirmed no abdominal aortic aneurysm, but discovered incidental findings of a 5.5×3×3.7 cm left-sided adrenal mass and a 1.5 cm gallbladder stone. He was treated for suspected cholecystitis and 24-h urinary free catecholamines requested. Unfortunately he was lost to follow-up.<...

Introduction: Osmotic demyelination syndrome (ODS) or commonly known as central pontine myelinolysis is commonly associated with rapid correction of hyponatraemia resulting in neurological deficits that manifests within days. The population commonly affected include alcohol dependence patients, the malnourished and liver failure patients. We describe a case of ODS developing in an alcoholic patient with symptoms developing 4 weeks after correcting hyponatraemia.<p class="a...

We present a case of a 52-year-old man with a past medical history of primary hypothyroidism on treatment, presenting with elevated TSH levels, suggesting inadequate thyroxine (T4) replacement. The patient was managed with 200 μg of T4 for 14 years with no compliance issues. TSH levels failed to normalise despite increasing the dose of T4. In addition to elevated TSH levels the patient noted progressive leg swelling and associated shortnes...

Introduction: Hyponatraemia, defined as serum sodium <135 mmol/l is one of the commonest electrolyte abnormalities seen in patients admitted to acute hospitals and is associated with increased morbidity and mortality. Impact of this condition is not adequately measured in critically ill patients admitted to intensive care unit. The aim of this observational study was to assess the incidence and outcomes of patients admitted to intensive care unit (ICU) in a UK based settin...