Endocrine Abstracts

Background: Intranasal steroids are commonly used for allergic rhinitis, rhinosinusitis and nasal polyps as they are considered safe in terms of long-term adverse effects profile due to favourable pharmacokinetic characteristics as compared to other oral and inhaled steroids. Some are also available over the counter without prescription.Case: We report a patient with iatrogenic Cushing”s syndrome and secondary adrenal insufficiency due to chronic in...

Hyponatremia due to water intoxication is often associated with mental disorders like schizophrenia and psychosis. Patients usually present with headaches, seizures and altered consciousness. The mainstay treatment in these cases is fluid restriction. A 31-year-old man was brought to the hospital following a fall and disorientation. He had a history of Schizophrenia which had been well controlled on risperidone. A few weeks before this presentation, he drank about 20 litres of...

Case History: A 68-year-old gentleman was admitted to the hospital following a history of weight loss, lethargy, tiredness for about 6 months. His past history includes hiatus hernia, esophagitis and kidney stones. He reported taking over the counter vitamin D (60,000 IU daily) for more than 2 years. He was not on any other regular medications.Investigations: His initial investigations showed acute kidney injury with severe PTH independent hypercalcaemia...

Patients with chronic schizophrenia and psychosis are prone to develop hyponatremia secondary to psychogenic polydipsia. Hyponatremia secondary to water intoxication and its rapid correction are linked with rhabdomyolysis, an under-recognized yet serious condition. We report a case of 31 year old male with schizophrenia on Risperidone, who was brought to the emergency due to an unwitnessed fall and confusion. Serum sodium was 111 mmol/l, urine osmolality 55 mosm/kg and urine s...

Background: Resection of the adrenal gland is a challenging intervention that requires close endocrinological supervision for the correct assessment of hormones to minimise complications peri-operatively (peri-op) and post-operatively (post-op).Objectives: This study assessed the function of the hypothalamus–pituitary–adrenal axis and the related management according to underlying adrenal disorders.Methods: We reviewed 16...

Benign Ethnic Neutropenia (BEN) is a common form of neutropenia defined as an absolute blood neutrophil count (ANC) of < 1.5 x 109/l, usually observed in Afro-Caribbeans. These patients are not at increased risk of infection despite their neutropenia, unless they are on medications which can cause neutropenia. Amongst these drugs antithyroid medications are known to cause agranulocytosis defined as ANC of <500/μl. We report a case of 24 years old male w...

Introduction: Phaeochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumours with no standardised protocol for treatment. 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) is an emerging treatment option for patients with metastatic and/or inoperable PPGL, and with low toxicity. We present our experience with PRRT in advanced PPGL, treated in a ENETS Centre of Excellence.Materials and Methods: 165 patients with...

Introduction: Gestational trophoblastic disease (GTD) is a group of disorders arising from abnormal proliferation of placental trophoblasts. Hydatiform mole (molar pregnancy) is a premalignant condition which is further devided in to partial and complete mole. Incidence of molar pregnancy is estimated to be 1 in 1000 pregnancies. Hyperthyroidism is one of the rare complications of molar pregnancy which, if not detected and treated, can lead to adverse consequences. We describe...

Introduction: Adrenocortical Carcinoma (ACC) is a rare endocrine neoplasm with poor prognosis, and an estimated incidence of approximately 2.5/1,000,000 patients. The functional state of these tumors varies from non-secretory (20%) to non-secretory. The latter category is subdivided into glucocorticoid-producing (45%) or glucocorticoid-androgen producing (45%) or androgen-producing only (10%). We report a case of a 35-year-old lady who initially presented with symptoms of Cush...

Introduction: Cushing’s syndrome is a rare endocrine disorder characterized by excess cortisol secretion. It can be caused by various etiologies, including ACTH-dependent and ACTH-independent forms. We report a case of a 78-year-old male who presented with severe hypertension, refractory hypokalemia, and severe hypercortisolaemia, diagnosed with ACTH-dependent Cushing’s syndrome with bilateral adrenal hyperplasia.Case Presentation: A 78-year-ol...