Endocrine Abstracts

Multiple parathyroid tumors causing hyperparathyroidism are the most common manifestation of multiple endocrine neoplasia type 1 (MEN1), displaying almost 100 percent penetrance by age 40–50 years. In most cases, it is the initial manifestation of MEN1.We report a case of young lady presented to hospital with diarrhoea and vomiting and diagnosed to have multiple peptic ulcers with severe oesophagitis. Her other biochemistry was consistent with prima...

As the SGLT-2i class gains popularity for management of type 2 diabetes (T2DM), the risk of diabetic ketoacidosis (DKA) has been recognised as a potential adverse event. However, all the reported cases of DKA associated with SGLT-2 inhibitors seem to have some additional predisposition to this condition and been exposed to alternative precipitants. We report a root-cause analysis of five locally presenting cases of DKA associated with dapagliflozin followed by a literature rev...

Thyrotoxic period paralysis is a rare endocrine emergency associated with hyperthyroidism that needs urgent treatment. We present a case of a 19-year-old Chinese student who was admitted with progressive weakness in his lower limbs developing overnight. He was resident at the students’ hostel and went to sleep after ignoring mild leg weakness overnight but could not even get up from his bed in the morning. Luckily his friend called the ambulance and brought him in hospita...

Hashimoto’s encephalopathy (HE) is a very rare neuropsychiatric condition associated with autoimmune thyroid disorders which shows a remarkable response to steroid therapy and hence is also called steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT). We report a case of 44 year old lady presenting twice with psycho-affective symptoms but not receiving the diagnosis on first presentation. She initially presented with 3 wee...

Introduction: Hypercalcaemia is a commonly encountered biochemical abnormality. The most common causes of hypercalcaemia are primary hyperparathyroidism and malignancy. Familial Hypocalciuric Hypercalcaemia (FHH) is a rare cause of hypercalcaemia.Case: We present a 53-year-old female, who was referred to the endocrinology clinic for further investigation of a persistent hypercalcaemia associated with low-to-normal parathyroid hormone level (1.5pmol/l). S...

A 60 year old Caucasian woman was referred to endocrine clinic with persistent hypercalcaemia between 2.8 and 2.9 mmol/l (2.2–2.6), with inappropriately normal PTH at 7 pmol/l (1.48–7.63). Her hypercalcaemia was noted first in 2008. She had no signs or symptoms associated with hypercalcemia. However, she has a strong family history of hypercalcaemia, where her mother required Cinacalcet to control her hypercalcaemia despite two previous parathyroid resections. She ha...

Introduction: Polyendocrine autoimmune syndrome is a group of disorder involving endocrine glands as a consequence of autoimmunity. Non-endocrine organs also may be affected. An association between autoimmunity and immunodeficiency has also been recognized. We report a case of polyglandular autoimmune disease associated with common variable immunodeficiency.Case report: A 26-year-old was diagnosed with Addison disease at the age of 4 following recurrent ...

: A family with generalised resistance to thyroid hormone secondary to a missense point mutation in thyroid hormone receptor β (TR-β) gene corresponding to substitution of arginine to histidine at amino acid 438 (R438H) is described in three successive generations.Case 1: (Index case) A 43 year old lady presented with thyrotoxicosis and was initially treated with carbimazole followed by radio-iodine ablation of the thyroid. Thyroxine was commen...

Adrenal haemorrhage is comparatively rare. A 64-year-old female presented with acute right sided abdominal and chest pain shortly after a left knee replacement. She had recently started treatment dose low molecular weight heparin for presumed DVT for persistent pain in the left knee. A subsequent Doppler study of left leg was negative for DVT but an abdominal US revealed a solid lesion at the upper pole of the left kidney. CT urography showed large bilateral adrenal masses. No...

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...