Endocrine Abstracts

Background: Hypercalcemia in patients with advanced chronic liver disease (CLD) without hepatic neoplasia is a rarely reported and poorly understood entity. CLD is usually associated with hypocalcaemia because of hypoalbuminemia. Hypercalcemia on the other hand is extremely rare and needs meticulous ruling out of other causes.Case Report: A 55-year-old male who was admitted with jaundice, weight loss and hypercalcaemia. He had a calcium that peaked at 3....

Background: Lactic acidosis is a common finding in critically ill patients. In patients with poorly controlled diabetes for a prolonged period of time, Glycogenic hepatopathy (GH), can cause lactic acidosis which is a rare condition that develops due to excessive accumulation of glycogen in the hepatocytes.Cases: Two cases with poorly controlled diabetes and glycogenic hepatopathy are presented. First patient was a 28 year old female with 20 year history...

A 65-year-old lady who was known to hypothyroidism and was treated with Levothyroxine 100microgram once daily for more than 20 years presented to the endocrine clinic with symptoms and signs of thyrotoxicosis. Apart from Levothyroxine, she was taking over-the-counter multivitamins and Vitamin D. Visual fields were full to confrontation and there was no goitre. Thyrotoxicosis was confirmed biochemically and levothyroxine was stopped. Despite being off Levothyroxine for more tha...

Background: Neuroendocrine tumours (NETs) are a heterogenous group of slow growing tumours with an increasing incidence. Disease-related diarrhoea, surgery and medical treatment can lead to malabsorption, resulting in vitamin deficiencies.Objective: To establish the prevalence of vitamin deficiencies in patients with NETs.Method: Retrospective review of NET patients seen since 2014 in South Wales across 6 health boards. Deficiencie...

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...

Introduction: Parathyroid cancer is a rare endocrine malignancy and constitutes 0.005% of all cancers. It can recur in 50% of cases. The first recurrence commonly occurs within 3 years of the original diagnosis. Hypercalcaemia is the main cause of morbidity and mortality. We present a case of a 62-year-old male patient who had an atypical lung nodule recurrence with normal calcium and PTH levels, six years following resection of a functioning parathyroid cancer.<p class="a...

Many patients continue complaining of subjective symptoms of hypothyroidism despite being on adequate doses of levothyroxine. There are about 14 studies involving T3+T4 combination including 7 which were rigorously conducted. Majority of them (11 studies) did not show any benefit of combination therapy. But our local experience has been a little different. We looked at small cohort of 15 patients who were on combination T3+T4 for more than 6 months and were asked...

Many patients continue complaining of subjective symptoms of hypothyroidism despite being on adequate doses of levothyroxine. There are about 14 studies involving T3+T4 combination including 7 which were rigorously conducted. Majority of them (11 studies) did not show any benefit of combination therapy. But our local experience has been a little different. We looked at small cohort of 15 patients who were on combination T3+T4 for more than 6 months and were asked...

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...