Endocrine Abstracts

Case History: A 69-year-old woman with bipolar schizoaffective disorder of 11 year’s duration and recent diagnosis of atrial fibrilation was admitted with acute onset of delirium, lethargy, shakiness and confusion. On admission, the patient was restless and non-compliant. Her skin was warm and sweaty, clinically dehydrated. Her heart rate ranging between 75 and 100 /min. The rhythm was irregular, consistent with atrial fibrillation on ECG and was afebrile. She was oriented to ...

A 64-year-old woman presented acutely with dry cough, difficulty in eating, diarrhoea and weight loss. Her past medical history included cervical carcinoma in situ treated with laser therapy. She was found to be hypercalcaemic, with a corrected calcium of 2.84 mmol/l. During admission, the calcium ranged between 2.8-3.87 mmol/l. The PTH ranged between 0.2-0.4 pmol/l (1.3-9.3 pmol/l). She had raised inflammatory markers and deranged liver function tests. On review, she...

Background: Carbohydrate loading is used to manage the neurovisceral attacks of the acute porphyrias. This presents difficulty when treating those with altered glucose homeostasis.Case history: A 17-year-old female presented with 5 days of abdominal pain and vomiting, her third acute presentation in eight months; the first with a seizure and second with bilateral lower limb weakness. All attendances were preceded by redu...

Hyponatraemia in pregnancy can be precipitated by various factors, including drugs, fluid excess and oxytocin infusion. It is a common complication of pre-eclampsia toxaemia (PET), although concomitant syndrome of inappropriate ADH secretion (SIADH) in this context is rare. We present a case of SIADH leading to hyponatraemia in a PET patient. A 30 year-old primigravid woman with bipolar disorder and hypertension was admitted with pre-eclampsia at gestational week 28. Her medic...

Background: There is a well-documented relationship between lithium exposure and thyroid dysfunction via multiple mechanisms. Lithium is commonly associated with goitre, hypothyroidism, and subclinical hypothyroidism. Lithium-induced autoimmune hyperthyroidism is rare and poorly understood. We report a case of autoimmune thyroiditis, Graves’ disease (GD), in a patient with longstanding primary hypothyroidism believed to be induced by Lithium.<p class=...

A 32 years old female, presented with bilateral moderate flank pain resolved with analgesics. She visited physician and advised CT Abdomen & Pelvis. It showed bilateral adrenal nodules. She referred to PKLI Urology & Endocrinology Department.Workup advised. Investigations: Normal TFT’s Ultrasound neck: normal thyroid gland with TI-RAD IV nodule in right lobe. AM cortisol 7.6 ng/dl Urine VMA 6.79 24 hour urinary metanephrines >600 and nor...

A 68-year-old woman presented with a several month history of nausea, confusion and generalised weakness. In addition, she reported decreased appetite with significant weight loss. She did not report any convulsions, abdominal pain, palpitations, or diarrhoea. Significant past medical history included well-controlled T2DM, hypertension, vitamin D deficiency and GI reflux disease. Importantly, she had no history of renal disease. Relevant medications incl...

A 68-year-old woman presented with a several month history of nausea, confusion and generalised weakness. In addition, she reported decreased appetite with significant weight loss. She did not report any convulsions, abdominal pain, palpitations, or diarrhoea. Significant past medical history included well-controlled T2DM, hypertension, vitamin D deficiency and GI reflux disease. Importantly, she had no history of renal disease. Relevant medications incl...

Introduction: Diaphoresis, or excessive sweating, is well recognised as a presenting complaint for endocrine disorders such as hyperthyroidism, acromegaly, and phaeochromocytoma. However, diaphoresis is an unusual presenting complaint for Cushing’s syndrome.Case: We present the case of a 35-year-old lady who first presented to health services for symptoms of excessive sweating, and feeling hot most of the time. Whilst initial investigations such as ...

Introduction: Graves’ disease is an autoimmune disorder which may lead to thyroid overactivity and eye disease. Oestrogen and progesterone are thought to be immunomodulatory and have been postulated to play an important role in the difference in prevalence of autoimmune disorders between men and women. Autoimmune disorders, including autoimmune thyroid disease, are often quiescent during pregnancy with an increased prevalence postpartum. The increase in immune mediated th...