Endocrine Abstracts

Case history: A 34 year old Chinese male was referred by GP as routine blood test which was done as part of investigation for ongoing hair loss that revealed hypocalcaemia. Patient was asymptomatic with no tingling sensation, numbness or anaesthesia. There was no history of carpopedal spasm, muscle pain or cramps. He does not give any history of symptoms suggestive of malabsorption. His PMH include Mild asthma and Eczema for which he was not on any regular medication. Social h...

Low potassium and magnesium are common findings found in patients seen on acute medical take which is often not followed up.A 23-year-old previously well Asian lady, presented with history of fatigue, weight loss and palpitations. She has been always thirsty and polyuric at night. There was history of tetany in childhood. There was a family history of an aunt who had Barter’s syndrome and her parents were first cousins.She had...

A 21-year-old gentleman, with known congenital adrenal hyperplasia (CAH) due to 21-hydroxylase-enzyme deficiency, presented to Genito Urinary Medicine clinic with dysuria. Examination of testes revealed bilateral firm lumps. Ultrasound scan showed bilateral testicular hypoechoic masses suspicious of malignancy. A second opinion ultrasound scan done at a tertiary care centre confirmed the same findings with the possibility of tumours being either seminoma or teratoma in origin....

Many patients continue complaining of subjective symptoms of hypothyroidism despite being on adequate doses of levothyroxine. There are about 14 studies involving T3+T4 combination including 7 which were rigorously conducted. Majority of them (11 studies) did not show any benefit of combination therapy. But our local experience has been a little different. We looked at small cohort of 15 patients who were on combination T3+T4 for more than 6 months and were asked...

Many patients continue complaining of subjective symptoms of hypothyroidism despite being on adequate doses of levothyroxine. There are about 14 studies involving T3+T4 combination including 7 which were rigorously conducted. Majority of them (11 studies) did not show any benefit of combination therapy. But our local experience has been a little different. We looked at small cohort of 15 patients who were on combination T3+T4 for more than 6 months and were asked...

A 12-year-old girl presented with dizziness, palpitations, headaches and sweating associated with hypertension (170/100 mmHg) and tachycardia (180 beats per minute). Repeated urinary and serum catecholamines were initially unremarkable. Routine biochemical and haematological testing was normal as were serum gut peptides. The patient was commenced on phenoxybenzamine, nifedipine and propranolol. This improved her symptoms, and corrected her tachycardia and raised blood pressure...

The link between exogenous steroid use and hypothalamo–pituitary–adrenal (HPA) axis suppression is well established. We present an unusual case where the use of an intra-oral steroid paste transiently obscured the diagnosis of Addison’s disease.A 45-year-old lady presented to hospital with a several week history of weight loss, nausea and vomiting, lethargy and postural dizziness. Physical examination was unremarkable except for hypotensio...

A 63-year-old gentleman with hypopituitarism secondary to non-functioning pituitary macro adenoma, treated with trans sphenoidal surgery 16 years earlier, was admitted with chest pain. His ECG showed 3 mm ST elevation in the inferolateral leads, and his subsequent cardiac enzymes were consistent with acute myocardial infarction. A decision was made not to thrombolyse him, as any intracranial tumour is an absolute contraindication to thrombolysis. He was discussed with the tert...

A 64 old year old obese (BMI 31 kg/m2) Caucasian male was admitted to our hospital with general malaise, nausea, vomiting and dehydration. He gave no preceding history of polyuria, polydipsia or weight loss. He had been receiving oral corticosteroids for established ulcerative colitis. He was found to have random plasma glucose of 70.7 mmol/l, positive serum and urine ketones, and metabolic acidosis with PH 7.27, bicarbonate 13 mmol/l and base excess −12.4. Th...

Adrenal incidentalomas is a common referral to endocrine department. We retrospectively looked at the number of referrals to the endocrine services with it over 1 year and their eventual outcomes. There were a total of 37 patients referred with adrenal incidentalomas to our department out of which 28 patients (76%) were non secretory, while 1 (3%) had catecholamine excess. 1 (3%) had mixed cortisol + catecholamine excess. 7(19%) patients either did n...