Endocrine Abstracts

A 34-year-old woman presented with a worsening headache 4 weeks post-partum following emergency caesarean section. She described the headache as the worst that she had experienced, and this was made worse by bending forwards and with associated photophobia. A CT head scan revealed pan sinusitis and a suggestion of a pituitary tumour while lab results showed mild hyponatremia along with low TSH and FT4. An initial working diagnosis of likely meningitis was made, and she commenc...

A 29 year old lady with a past history of seronegative rheumatoid arthritis, Vitamin B12 deficiency, autoimmune hypothyroidism and fibromyalgia who had feeling unwell with a left sided headache for a few days had a fall at home witnessed by her friend. She was noted to be in peri arrest state by ambulance crew on their arrival. Agonal breathing was noted and monitor revealed VF. She was given 5 DC shocks with return of spontaneous circulation and regained consciousness. She wa...

A 32-year-old primigravida woman, low risk pregnancy, BMI 20, presented at 29 weeks of gestation with headache and mildly raised blood pressure and normal laboratory tests. The patient had no signifcant medical history and the pregnancy to date had been uneventful. Physical examination showed blood pressure (BP) of 145/93 mm Hg. (Baseline, 100/70 mm Hg). Laboratory tests showed a baseline sodium of 134 mmol/l, with the rest of the biochemistry normal. She had been commenced on...

Introduction: Pancreatitis due to hypercalcemia from primary hyperparathyroidism is rare with an incidence of 1–1.5%. We report on a case of recurrent pancreatitis secondary to an ectopic parathyroid adenoma with co-existing severe vitamin D deficiency with its management difficulties.Case report: A 45-year-old male admitted to the hospital with abdominal pain and attendant nausea had investigations ruling out structural lesions for his symptoms but...

A 79-year-old man presented with a fall and vomiting. The finding of significant postural hypotension associated with severe hypotonic hyponatraemia (Na 114 mmol/L, Osmolarity 244 mmol/L) mandated a Short Synacthen Test (cortisol 98 mmol/L at baseline and 238 mmol/L 30-minute post synacthen) and ACTH (6 ng/L) which confirmed central hypoadrenalism. This led to revelation of multiple pituitary axes involvement: hypogonadism (testosterone 1...

A 79-year-old man presented with a fall and vomiting. The finding of significant postural hypotension associated with severe hypotonic hyponatraemia (Na 114 mmol/L, Osmolarity 244 mmol/L) mandated a Short Synacthen Test (cortisol 98 mmol/L at baseline and 238 mmol/L 30-minute post synacthen) and ACTH (6 ng/L) which confirmed central hypoadrenalism. This led to revelation of multiple pituitary axes involvement: hypogonadism (testosterone 1...

Introduction: Adrenal vascular cysts are rare, in most cases incidentally discovered during abdominal imaging for other reasons. We present a case of adrenal endovascular cyst with initial suspicious features of adrenal malignancy and subsequent management and complications.Case report: This 72-year-old male was initially admitted with a weight loss over 2 months and new onset fever and rigors and right leg pain. He was noted to have an abdominal mass. H...

Background: Thioamide-resistant severe Graves’ thyrotoxicosis (SGT) is rare and often poor patient adherence to therapy is suspected. Management is truly challenging. Case report: 36-year-old female with SGT was referred for further management. The diagnosis was made 5 years ago following delivery of her first son. During her second pregnancy 2 years ago, she required emergency caesarean with the indication of foetal tac...

Case history: A frail 79 years old lady with dementia presented with frequent falls since 2 years ago. Neurologist’s assessment had attributed her fainting episodes to migraine. She later was found to have biochemically evident recurrent hypoglycaemia requiring multiple admissions and eventually continuous glucose infusion to maintain euglycemia.Investigations: The severe spontaneous hypoglycaemia in this non-diabetic lady prompted investigations. T...

Case: A 79 years old frail lady with history of dementia and hypertension presented with refractory hypoglycaemia over a period of 3 months requiring multiple admissions. During her most recent admission, she required continuous dextrose infusion to maintain euglycaemia. The severe spontaneous hypoglycaemia in this non-diabetic lady, warranted a series of investigations. TFT and Short Synacthen Test excluded thyroid dysfunction and hypoad...