Endocrine Abstracts

Case History: A 68-year-old gentleman was admitted to the hospital following a history of weight loss, lethargy, tiredness for about 6 months. His past history includes hiatus hernia, esophagitis and kidney stones. He reported taking over the counter vitamin D (60,000 IU daily) for more than 2 years. He was not on any other regular medications.Investigations: His initial investigations showed acute kidney injury with severe PTH independent hypercalcaemia...

Background: Success of Graves’ orbitopathy (GO) immunosuppression treatment is highly variable; patients relapse and a debilitating residual disease burden often remains with current therapies. This study describes the outcomes of immunosuppression in a multi-ethnic GO cohort treated in accordance with pre-2021 European Group on GO (EUGOGO) guidelines with first-line intravenous-methylprednisolone (IVMP). This study aims: (1) To evaluate the effect of first-line and addit...

Introduction: Adrenal incidentalomas (AIs) are increasingly being identified due to more frequent use of cross-sectional imaging modalities. Recent studies reported AIs being identified in 7.3% of abdominal CT imaging. Most adrenal incidentalomas are adenomas that may have secretory activity.Case Report: An 80-year-old lady presented to our Emergency department with one week’s history of worsening right eye bulging and discomfort. She was found to h...

Background and Aims: The objective of our study is to evaluate the degenerative profile in diabetic patients and their glycemic controlMaterials and Methods: This analytical cross-sectional study for analytical purposes was conducted during the period from January 2022 to January 2023, within the department of endocrinology and metabolic diseases of the Military Hospital of Instruction Mohamed V of Rabat.Results: 215 patients were ...

Background: Diagnostic work-up for Cushing Syndrome (CS) can be challenging and is based on clinical and biochemical assessments. Biochemical evidence of endogenous steroid excess is demonstrated through overnight dexamethasone suppression test (ODST), low dose dexamethasone suppression test and/or 24-hour urinary free cortisol estimation (UFC). Once endogenous steroid excess is confirmed, random serum ACTH measurement is key in determining the suspected source of steroid exce...

We present two cases of alternative approaches to treating endocrine disease. Case 1: A 55-year-old man became steroid dependent in 2017, following a skiing accident and C3/4 fracture, for which he received 13-months of high-dose hydrocortisone. Upon cessation, he developed adrenal crisis, confirmed on short synacthen test. Hydrocortisone replacement therapy was begun. His dose was doubled, then tripled to control his symptoms, in addition to frequent re...

Section 1: Case history: A 69-year-old female with a past history of treated hypertension and Graves’ disease presented to the emergency department with a two-day history of headaches, vomiting, confusion and difficulty swallowing following a recent holiday in Spain. She had clinical meningism and a diagnosis of meningitis was made.Section 2: Investigations: After an initial CT scan of her head was reported as unremarkable, a lumbar puncture was per...

Case history: 49 year old female with learning disabilities who was being treated as epilepsy for 2 years and attended the GP surgery for routine bloods. Patient had a seizure like activity and fell onto both knees. X ray which showed a distal femur fracture which was undisplaced and was extra-articular and patellar fracture. Patient was found to be hypoglycaemic on the ward and she was treated with 10% dextrose infusions. She underwent Left knee exploration and repair of medi...

Introduction: In 2017 the Roche cortisol assay underwent a generation update. The increased specificity of this assay was expected to lower cortisol results by approximately 30%. Based on a local consensus, the 30 min short Synacthen Test (SST) cortisol was lowered from 550 to 420 nmol/l. With the previous assay, a morning cortisol of ≥375 nmol/L gave a 99% PPV of an SST ‘pass’.Aims: • To compare the numbers of SSTs and the SST pass ...

Case history: A 44 year old black African woman was referred to the endocrinology clinic for investigation of abnormal thyroid function tests. She had initially presented with palpitations and sweats. She had no significant past medical history and was not taking any prescribed medications or over the counter preparations. On examination, she was clinically euthyroid and did not have any abnormal findings of note.Investigations: Biochemical investigation...