Endocrine Abstracts

Introduction: Cushing’s syndrome (CS) is a rare disease that can be difficult to diagnose. 24 hour urinary free cortisol (UFC) is one of the reliable screening tests to diagnose CS. The Endocrine Society recommends against widespread screening for CS. It advises to screen those patients presenting with multiple and progressive features (easy bruising, facial plethora, proximal myopathy and striae) of CS, in addition to patients who experience unusual features for their ag...

Background: Treating life-threatening diabetic ketoacidosis (DKA) with a pH of <6.9 is extremely challenging and often refractory to treatment using standard fixed dose insulin DKA management protocols which may not work effectively at this low pH because of increased insulin resistance. I.v. bicarbonate (HCO3) use in this situation can be considered but remains controversial due to the risk of significant side effects as well as limited evidence in literature. ...

Serum androgen levels are commonly suppressed in patients with benign cortisol-secreting adrenocortical adenomas due to ACTH suppression. Associated androgen co-secretion usually indicates malignancy. Here, we present a case a very large benign androgen and cortisol-secreting adrenocortical neoplasm.Case: A 24-year-old female was referred with a 1-year history of secondary amenorrhea associated with hirsutism and acne. She reported irregular menstrual cy...

Background: In steroid dependent patients the knowledge of steroid dose change during illness and stress is of paramount importance.Objectives: i) To assess patient’s knowledge of steroid management during acute illness and stressful condition. ii) To evaluate whether there is a relation between patient knowledge and admission with documented adrenal crisis. iii) To improve medical access to information about patients on steroid at Emergency Departm...

Background: Diabetes is a risk factor for both PAD and PAD-associated mortality. Diabetic patients have worse arterial disease and a poorer outcome than nondiabetic patients. Fetuins are blood proteins made in the liver more abundant in fetal blood. Fetuin-A is regarded as an inhibitor of systemic calcification.Aim of this work: To assess the relationship between plasma fetuin-A levels and peripheral vascular disease in type 2 diabetes mellitus.<p cl...

Introduction: Brain metastases of thyroid carcinomas are rare (0.1–5%) according to the literature data. They generally occur in a context of metastatic spread which has a serious impact on survival. We report two cases and will review the literature data.Observations: Case 1: 57-year-old patient monitoring for papillary thyroid carcinoma in its solid form trabecular classified T4N0M1with lung metastases. Following a neurological symptoms of tonic-c...

Introduction: Papillary thyroid carcinoma (PTC) has generally good prognosis, and distant spread is rare. Common sites of distant metastasis are lung parenchyma and bone. Pleural metastasis is less common (0.6%), and most cases have been detected because of pleural effusion. Malignant pleural effusion is a poor prognostic factor among patients with PTC. We report a case of pleural metastasis of PTC proved by pleural biopsy.Case report: A 62-year-old man ...

Evidence from studies in goats1, sheep2 and mice3 suggests that the kisspeptin cells of the arcuate nucleus generate the signal that causes the pulsatile secretion of GnRH. This effect may be due to action of kisspeptin on GnRH terminals in the median eminence3,4. We conducted studies on sheep to test the hypothesis that kisspeptin cells of the arcuate nucleus (ARC) and/or the glutamate cells of the hypothalamus pulses of GnRH secret...

Introduction: Patients with hypothyroidism are routinely advised to take levothyroxine without food or beverages but the pharmacokinetic effect of many common foods are unknown. We describe a patient with an unusually high levothyroxine requirement who only achieved adequate replacement by taking grapes along with levothyroxine. Through a cycle of challenge, withdrawal, and-re-challenge, we were able to demonstrate that levothyroxine availability was enhanced by grapes in this...

Background: Although risk factors for diabetic foot ulceration (DFU) have been extensively studied in patients with diabetes in Egypt, there is surprisingly limited evidence among those on chronic hemodialysis (CHD).Aims: To investigate the risk factors for foot ulceration in adult patients with diabetes with end stage renal disease on hemodialysis in Dakahlia Governorate central hemodialysis units.Patients and methods: This Cross-...