Endocrine Abstracts

We present the case of 78-year-old female admitted to our hospital in January 2023 with recurrent hypoglycaemic episodes during fasting periods, particularly overnight and early morning. The patient had impaired hypoglycaemia awareness and cognitive decline. The only past medical history was of hypertension treated with bendroflumethiazide and amlodipine. During hospital stay, she experienced multiple hypoglycaemic episodes. Biochemical investigations revealed non-insulin-depe...

We report an interesting case of a rare presentation of hypercalcemia in a 27-year-old pregnant woman with history of Uterine fibroids. The patient arrived at the emergency department with two weeks history of worsening lower abdominal pain. She had resorted to sleeping in a sitting position due to the intensity of pain. There was no vaginal bleeding and bowels were not opened for four days. Physical examination revealed dehydration, tenderness in the lower abdomen with an abd...

Background: Combination treatment with Levothyroxine (LT4) and Liothyronine (LT3) in primary hypothyroidism has been debated recently due to restrictions placed by local health boards. National guidance suggests that a short-term trial of combination LT4/LT3 treatment may be considered for individuals who report persistent symptoms despite adequate LT4 replacement.Method: We created a prescribing protocol for combined LT...

Purpose: Inclisiran is the first small interfering RNA (siRNA)-based treatment approved to reduce pro-atherogenic lipoproteins in patients with heterozygous familial hypercholesterolemia (HeFH) or clinical atherosclerotic cardiovascular disease (ASCVD), who require additional lowering of low-density lipoprotein cholesterol (LDL-C). We report, to the best of our knowledge, the first evaluation of its effects in a Middle Eastern population.Methods: Retrosp...

Introduction: Immobilization hypercalcemia is uncommon condition associated with limited movements following brain and spinal cord lesions. Immobilization results in stimulation of osteoclastic bone resorption hypercalciuria and hypercalcemia.Case report: 57 year female, Background of Breast Cancer (Treated with Skin sparing mastectomy and adjuvant radiotherapy) admitted following large subdural hematoma leading to craniotomy and evacuation of hematoma. ...

Introduction: Paraneoplastic endocrine syndrome such as hypercalcemia in malignancy is well-known. However, paraneoplastic insulin resistance is rarely described and its management is challenging.Case history: A 33 years old teetotal gentleman with BMI of 37.5 kg/m2 and histological diagnosis of desmoid tumour presented with osmotic symptoms, weight loss, hyperglycemia and normal ketones. He was hemodynamically stable with no clinical or bioch...

Background: A 73-year-old female presented to the hospital with a 3-day history of right upper quadrant abdominal pain and episodes of vomiting. Her past medical history included insulin treated Type 2 diabetes diabetes, deep venous thrombosis for which she was on rivaroxaban, COPD, right leg angioplasty and previous p-ANCA vasculitis. She also had flank tenderness and was noted to be hypertensive with a blood pressure of 225/93mmHg. A CT scan of the abdomen identified a new 4...

Background: Normocalcaemic primary hyperparathyroidism (NPHPT) can be considered as an early biochemical manifestation of hypercalcaemic primary hyperparathyroidism (PHPT). Vitamin D repletion and exclusion of other conditions is recommended before diagnosing NPHPT. It is often challenging to distinguish Vitamin D deficiency associated secondary hyperparathyroidism (SHPT) from NPHPT and the two conditions may coexist. A parathyroid function (PF) index [(Parathyroid hormone (PT...

Introduction: Thionamides are the mainstay of management of thyrotoxicosis but can be associated with adverse effects like agranulocystosis, hepatitis and vasculitis. While radioactive iodine and thyroidectomy can be utilized in such scenarios, they were not timely available during the COVID pandemic. We present our experience of using cholestyramine as monotherapy.Case Series: Our series consists of four females. Graves’ disease was the underlying ...

Craniopharyngioma is a rare embryonic malformation of the Sellar/parasellar region. This harbors BRAF-V600E mutations. There are 2 Subtypes-Adamantinomatous and Papillary. Point prevalence of CP is around 2/100,000 with no variance by gender or race. CP has bimodal age distribution with peak incidence in the ages of 5-14 and 65-74 years. CP presents with following clinical features: Symptoms due to increased intracranial pressure-Nausea, headaches, visual impairments, hormone ...