Endocrine Abstracts

Hypoparathyroidism following parathyroidectomy is commonly treated with activated vitamin D, (alfacalcidol and calcitriol). Alfacalcidol (1-hydroxyvitamin D) is converted by hepatic 25-hydroxylase to generate calcitriol (1,25-dihydroxyvitamin D) to act on target cells.We present the case of 66 year old man who was admitted with chest pain in November 2016 and found to have corrected calcium of 1.5 mmol/litre and PO4 2.7 mmol/litre....

Hypoparathyroidism following parathyroidectomy is commonly treated with activated vitamin D, (alfacalcidol and calcitriol). Alfacalcidol (1-hydroxyvitamin D) is converted by hepatic 25-hydroxylase to generate calcitriol (1,25-dihydroxyvitamin D) to act on target cells.We present the case of 66 year old man who was admitted with chest pain in November 2016 and found to have corrected calcium of 1.5 mmol/litre and PO4 2.7 mmol/litre....

Aim: Recent studies reported a wide range in baseline and peak cortisol responses to surgery. We report the results of cosyntropin stimulation testing following unilateral adrenalectomy for non-steroid secreting lesions.Methods: Data of 36 patients who underwent cosyntropin stimulation testing on the second day post unilateral adrenalectomy were collected retrospectively. None of the patients had clinical signs of hypercortisolism. No patient received pr...

Case History: A 30 year old woman presented with the history of swollen painful eyes for 4 weeks while visiting Italy. She had a background of Hashimoto’s Thyroiditis since 2010 and was treated with levothyroxine 100 mcg once daily. She was given a course of oral steroids for 2 weeks and her thyroxine dose was reduced to 25 mcg once daily in Italy. Since then, her orbital swelling began to improve. She was a non-smoker. On examination, she was noted to have bilateral mild...

Prolactinomas are the most common hormone-secreting pituitary tumors. They typically present with hypogonadism, decreased libido, infertility, and gynaecomastia in men. We present an interesting case of a 44-year-old gentleman who was referred to our endocrine clinic for ‘abnormal thyroid function tests’ with a low T4 despite a normal TSH (TSH 2.01, T4 7.5, T3 3.9). He reported a few years’ history of increasing weight gain and lethargy, generalized aches and pa...

Alemtuzumab, a humanized anti-CD52 monoclonal antibody is effective in treating multiple sclerosis. However, it has been associated with thyroid disorder in up to 30–40% patients. While Graves’ disease is the most common disorder (70%), thyroiditis has been reported up to 4.9% cases.Case 1: 34 year old woman with the background of multiple sclerosis and autoimmune hypothyroidism (on levothyroxine 50 mcg OD) was given Alemtuzumab infusion in Jul...

Ectopic adrenocorticotropic hormone (ACTH) production is a rare cause of Cushing’s syndrome. It is usually seen with small cell lung cancer, bronchial carcinoid, or medullary thyroid cancer. Rarely, the source of ectopic ACTH production can be a phaeochromocytoma. A 55 year old gentleman presented to a general physician following an episode of presumed gastroenteritis with vomiting and general malaise. Further episodes of diarrhoea, joint pains and palpitations followed. ...

Due to availability of easy routine blood testing, normocalcaemic primary hyperparathyroidism is increasingly seen. However, due to its mild nature, it often poses diagnostic difficulties. We present a case of 65 year old gentleman who was diagnosed with osteoporosis in 2015. He had a history of traumatic fractures of tibia, fibula and calcaneum in 2013. He was later diagnosed with unexplained osteoporosis in 2015 (T-score of hip −2.5 and T-score of spine −1.2) and...

Endocrinopathies are common complications following cancer therapy and may occur decades later. We present a case of 37 year old lady with a background of chronic myeloid leukaemia (CML) which was treated with sibling allogenic stem cell transplant and total body irradiation in 2002. She was noted to have elevated calcium levels with raised PTH 10 years later. In view of young age, she underwent genetic screening for MEN1 through buccal swab as her lymphocytes were not suitabl...

Hypogonadism persisting in males with macroprolactinoma requires exogenous testosterone replacement therapy but this may cause secondary elevations of prolactin. We present a case of a 44 year old gentleman who was diagnosed with macroprolactinoma after being investigated for ‘abnormal thyroid function tests’ with a low T4 and a normal TSH. He reported a few years’ history of increasing weight gain, lethargy, generalised aches and pains, occasional headaches and...