Endocrine Abstracts

Background: The presence of Adrenocorticotropic hormone (ACTH)-independent Cushing syndrome that is associated with androgen hypersecretion is extremely rare in benign adrenal tumors. Precise recognition and management of this association will have a great impact on the management of such patient.Clinical case: We describe a case of a 35-year-old lady who presented with 2 years history of difficult-to-control hypertension, symptoms of androgen excess alo...

Autosomal Dominant Hypocalcaemia (ADH) type 1 is caused by activating mutations of the calcium-sensing receptor (CaSR) gene. Although a rare condition, the exact prevalence is uncertain as patients are asymptomatic and, historically, were sometimes diagnosed with hypoparathyroidism (HPT) due insensitivity of earlier PTH assays and failure to check urinary calcium. The consequences of an erroneous diagnosis of HPT in patients with ADH can be profound, as treatment with calcium ...

A 49-year-old lady was referred to the endocrine clinic for hypophosphataemia. Apart from tiredness, she had no other symptoms. Past medical history was significant for bronchiectasis, obstructive sleeps apnoea, caudaequina syndrome, migraine and anxiety. She had frequent hospitalisations due to bronchiectasis exacerbations requiring systemic steroids. Usual medications included azithromycin, gabapentin, omeprazole, antacids, laxatives, carbocisteine, fluoxetine, montelukast, ...

Objectives: to evaluate the clinical and biochemical effects of (SGLT2) inhibitors as a fourth oral anti-diabetic drug in patients with type 2 diabetes mellitus (T2DM).Patients (Materials) and Methods: In a tertiary hospital in Karachi, Pakistan, a retrospective assessment of patient medical records was conducted from January 1, 2017 to December 31, 2020.A total of 100 patients (mean age [Standard Deviation]: 53.8 [9.63] years) with poorly controlled T2D...

Context: Pheochromocytoma and Paragangliomas (PPGL) are rare neuroendocrine tumors with a strong genetic background. In this report, our objectives are to understand the molecular genetics and the genotype/phenotype correlation of these tumors in the highly consanguineous population of Saudi Arabia. Patients and methods: We studied 88 patients with PPGL and no known family history of these tumors. We extracted DNA from peripheral leucocytes and performed...

A male with classical salt-wasting congenital adrenal hyperplasia (CAH; 21-hydroxylase deficiency) who was diagnosed in infancy and had normal pubertal growth and development attended the endocrine department for routine follow up in June 2019 (age 26). His current daily medications are hydrocortisone 10 mg on waking, 5 mg at 4 pm and fludrocortisone 200 mg once daily. He also has injectable hydrocortisone sodium phosphate 100mg for emergency use. Over recent years, he reports...

A 17 year-old female was referred to Endocrinology with primary amenorrhoea and arrested puberty (B4 PH4 AH2). She reported breast development in line with her peer group and had experienced a single “show” of vaginal spotting aged 15 years. Although guidelines recommend baseline pelvic USS in the investigation of primary amenorrhoea, it generally only adds value in females with high LH+FSH and abnormal karyotype; indeed, it may raise undue concerns of uterine (Mulle...

Case history: A 26-year-old female presented with acute left-sided loin pain. There was a preceding dull ache for two months. She had no dysuria or haematuria. Her past medical history was unremarkable except for rhinosinusitis. Investigations: Abdominal CT revealed oval shaped lesion adjacent to the upper pole of the left kidney. The left adrenal gland could not be separately visualized. The lesion had mass effect on the fundus of the stomach. Adrenal M...

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...