Endocrine Abstracts

A 25-year-old lady with poorly controlled type I diabetes presented acutely with vomiting, peripheral oedema and abdominal distention.She was diagnosed with type I diabetes at the age of 12 and her glycaemic control has always been suboptimal predominantly due to poor compliance with the treatment. She had had numerous admissions with diabetic ketoacidosis in the past.On examination a tender hepatomegaly was noted. The investigatio...

This lady with a background of schizophrenia and depression, on long term lithium therapy, initially presented in 2002, at the age of 53, with acute renal failure and symptoms of lithium toxicity secondary to sepsis. Lithium level measured at the time was 2.5 mEq/l and her creatinine 314 μmol/l. She was normocalcaemic on admission. The patient was hospitalized on ICU and the treatment included ventilation, haemofiltration and inotropic support.On 10...

Introduction: Tolvaptan is an oral vasopressin V2 receptor antagonist which offers a novel treatment for euvolaemic and hypervolaemic hyponatraemia. Here, we report our experience with Tolvaptan in elderly patients.Case 1: Seventy sex-year-old lady with background of hypothyroidism, hypertension and alcohol excess presented with acute onset of confusion. Her admission Sodium [Na+] level was 117 mmol/l and represented an acute drop f...

A 48-year-old healthy, normotensive male was referred by GP due to incidental finding of hypokalaemia of 2.5 mmol/L on routine blood testing. The patient was initially treated with oral potassium supplements with little effect. Biochemical investigations in the endocrine clinic demonstrated mild metabolic alkalosis, eunatraemia, mild hypomagnesaemia 0.6 mmol/L and hypercalcaemia of 2.84 mmol/L with hypophosphataemia of 0.53 mmol/L. PTH was high at 350 ng/L. Renin and aldostero...

A 66-year-old HIV positive male presented to gastroeneterologist with a 2 months history of severe fatigue, weight loss, dizziness and nausea. He had background of ulcerative colitis which was quiescent and he has not received steroids for more than 12 months. Baseline blood results revealed normal biochemistry with mild normocytic anaemia, neutropaenia and lymphopaenia. As there was a high clinical suspicion of adrenal insufficiency, the short synacthen test was performed whi...