Endocrine Abstracts

Introduction: Osteoporosis can be associated with Cushing syndrome or hyperthyroidism but is an unusual finding in a patient with primary adrenal insufficiency (with physiological dose of steroid replacement) and concurrent autoimmune hypothyroidism without any other secondary causes of osteoporosis. We present a case of severe osteoporosis in a postmenopausal female in whom we could not establish a verifiable cause. Case: A 60-year-old postmenopausal wo...

Parathyroid hormone is a polypeptide consisting of 84 amino acids. Quantification of circulating intact PTH assists in the differential diagnosis of hypercalcemia. It is important to interpret PTH results with caution and to keep in mind Immunoassays interference can also be a reason of falsely high PTH levels. We present an interesting case referred with high parathyroid hormone levels. A 74 years old female attended clinic with raised PTH levels of 11.7 pmol/l, a normal calc...

Pseudohypoparathyroidism type 1b (PHPT1b) is a rare disorder due to resistance to parathyroid hormone (PTH) and subsequent hypocalcaemia, hyperphosphataemia and normal or raised PTH levels. Sufferers usually present in childhood with seizures or tetany due to hypocalcaemia. Typically, PHPT1b is associated with defects on the long-arm of chromosome 20 in the form of uniparental (paternal) disomy of 20q or genetic mutations or sporadic epigenetic changes in GNAS gene. G...

Background: Measurements of thyrotropin (TSH), free thyroxine (FT4) and triiodothyronine (FT3) are widely used diagnostic methods for thyroid function evaluation. However, some serum samples will demonstrate a nonspecific binding with assay reagents that can interfere with the measurement of these hormones. Few case reports of TSH interfering antibodies have described the presence of such interferences resulting in reported abnormal concentrations of thyroid hormones. Unusual ...

Background: Postural hypotension has been commonly described in elderly. Common causes include medication, fluid loss, adrenal insufficiency and autonomic dysfunction. Hyponatremia is not a disease in itself, but a manifestation of a variety of disorders and side-effects of diuretics; alternatively, it may be the only manifestation of certain disorders. We present a case of primary hypothyroidism presenting as collapse with postural hypotension and severe hyponatremia.<p c...

Background: Sunitinib is a tyrosine kinase inhibitor used in the treatment of metastatic GIST and renal cell carcinoma. Tyrosine kinase receptors are involved in tumour growth, angiogenesis and metastatic invasion. It can cause hypothyroidism but few cases have actually been reported. Mechanisms suggested for the incidence of hypothyroidism include antithyroperoxidase activity,1 and blocking uptake of iodine in the thyroid gland,2 or it may induce destruc...

IntroductionDiabetes mellitus (DM) is a global health issue. Sri Lanka has the second highest diabetes prevalence at 20–79 years in South-East-Asia (1). Diabetic-radiculoplexus-neuropathy is a rare entity causing significant disability, also known as diabetic amyotrophy and Bruns-Garland syndrome, occurring due to immune mediated microvasculitis (2). Although Diabetic-lumbo-sacral-radiculoplexes-neuropathy (DLRPN) is well described, Diabetic-cervica...

30 yr/F, presented with C/O of palpitations, heat intolerance, significant unintentional weight loss with bulging of eyes and diplopia on extremes of vision. She had a background history of asthma, PCOS, obesity and difficulty in conceiving. OE, there was a smooth painless goiter. TFTs at diagnosis: TSH <0.05, T4=83, T3 >30.8 and TSH receptor antibody level (TRAB) of 9.0. She developed skin reaction to both Carbimazole and PTU, hence treated with total thyroidectomy wi...

Background: Diabetic striatopathy (DS) is a rare dyskinetic syndrome associated with acute decompensated hyperglycemia that commonly presents as hemichorea-ballism. Its natural history following resolution of the hyperglycemic crisis is not well delineated.Methods: The study was a prospective evaluation of the long-term clinico-radiological outcomes of patients presenting with DS. Neuroimaging (CT/MRI) was performed at baseline and follow-up (>3 mont...

Long-term diabetes is associated with accelerated ageing of the brain as evidence by impairment of cognitive function as well as motor performance. The aim of this study was to investigate the effects of voluntary daily exercise and environmental enrichment on spatial memory and learning as well as motor coordination and learning, in diabetic mice. Briefly, BALB/C mice (20–25 g) received 55 mg/kg streptozotocin i.p. daily for 5 days. Diabetes was confirmed by measurement ...