Endocrine Abstracts

A 29y female presented with an 8y history of hypomagnesaemia. It was noted incidentally when hospitalised with mumps-related pancreatitis. Subsequently symptomatic hypomagnesaemia, with headaches and lethargy, was treated with magnesium glycerol phosphate 4 mg TDS, but she remained symptomatic with occasional need of IV Mg2+. It was thought that she was poorly compliant with her oral Mg2+ supplements. At presentation to our department for follow-up of her...

Objective: To prospectively evaluate the results of laparoscopic ileal interposition (II) with diverted sleeve gastrectomy (DSG) for control of type 2 diabetes mellitus (T2DM) and related metabolic abnormalities.Methods: All patients underwent II+DSG. They had T2DM ≥5 years with poor glycemic control despite adequate dosage of oral hypoglycemic agents (OHAs) and/ or insulin. The primary outcome was remission of diabetes (HbA1C <6.5% without OHA...

Background: Arginine vasopressin (AVP) changes during altitude acclimatization is of clinical interest as increases in their plasma levels (with reference to sea-level (SL)) have been associated with fluid retention accompanied by elevated plasma cortisol levels. Studies have reported no change/ decrease in plasma AVP during ‘normal’ acclimatization. This study was conducted to evaluate plasma AVP changes and the associated physiological changes during chronic exposu...

Myxedema coma has very high mortality and should be suspected in an acutely unwell patient presenting with depressed mental status who is hypothermic, bradycardic and or hypotensive. Myxedema coma may be the first presentation of people with undiagnosed hypothyroidism. Definitive management is with thyroid hormone but supportive measures, identification and treatment of precipitating factors in an appropriately safe environment are vital. There is no consensus about preferred ...

Background: Parkinson’s disease (PD) is a neurodegenerative disease and a movement disorder characterized by loss of dopaminergic neurons in the substantia nigra causing dopamine depletion in the striatum. Neurodegeneration in PD occurs due to multiple pathways including oxidative stress, mitochondrial damage, protein aggregation. These changes increase during menopausal condition in females when the level of estradiol is decreased. Recently, there has been a growing inte...

Case Summary: A 72 year-old man presented with a one month history of anorexia, weight loss, lethargy, constipation, increased thirst and generalised aches and pains. He had a background of hypertension, ischaemic heart disease, aortic stenosis, and a renal transplant 23 years ago with declining renal function. No significant abnormalities were noted on physical examination. Investigations confirmed hypercalcaemia, with serum calcium rising from 2.8–3.05 mmol/l. This was ...

Hypoglycemia is an uncommon clinical problem in patients without diabetes mellitus. Potential aetiologies include drugs, critical illness, hormone deficiencies, and non islet cell tumors. In the absence of these causes, the possibility of accidental, surreptitious, or even malicious hypoglycemia should be considered. We present three cases of severe, prolonged hypoglycemia occurring spontaneously in healthy young men without a history of diabetes mellitus or chronic illness. A...

Introduction: A 59-year-old gentleman with longstanding poorly controlled type 2 diabetes mellitus, obesity, hypertension, obstructive sleep apnoea, depression and type 2 respiratory failure was seen in diabetes review clinic and noted to have truncal obesity, moon facies and wasting of the proximal muscles.Investigations: Urinary free cortisol was 782 nmol/24 h (NR <200). Midnight cortisol was 595 and 532 nmol/l on consecutive days. After low dose d...

The guidelines for the treatment of pituitary apoplexy have now been published in Clinical Endocrinology (Clin Endocrinol 2011 Jan;74(1):9–20). These resulted from a group set up during the London pituitary multidisciplinary meeting.Classical pituitary apoplexy is a medical emergency and rapid replacement with hydrocortisone maybe life saving. It is a clinical syndrome characterised by the sudden onset of headache, vomiting, visual imp...

Introduction: Non-alcoholic steatohepatitis (NASH) is part of the spectrum of non-alcoholic fatty liver disease (NAFLD). NASH commonly occurs in patients with type 2 DM and is less recognised in type 1 DM. The natural history of NASH in adult patients suggests potential development of progressive fibrosis and cirrhosis. However, secondary glycogenosis, commonly occurs in type 1 DM, is reversible when good glycaemic control is achieved, but may be misidentified as NASH b...