Endocrine Abstracts

Introduction: Milk-alkali syndrome is characterized by the triad of hypercalcaemia, metabolic alkalosis, and acute kidney injury and occurs due to excessive use of elemental calcium. Despite the widespread use of proton pump inhibitors, it is the third most common cause of hypercalcaemia after primary hyperparathyroidism and malignancy.Case presentation: A previously normocalcaemic 33-year-old patient presented at 34 weeks gestation, feeling non-specific...

Background and aims: Diabetic foot osteomyelitis (DFO) is a well-recognised complication and a risk factor for lower limb loss. Its effective treatment can reduce the risk of minor and major amputations. Our aim was to compare the yield in cultures from the proximal and distal segments of bone excised intraoperatively as part of the management of DFO and the impact on antibiotic choice and duration.Materials and methods: Patients attending the diabetic f...

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...

: 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...

Background: A previous short Synacthen test (SST) audit in our hospital (2012) showed 70% of initial SST tests were normal with 9% inappropriate requests. A new pro forma was devised whereby one of four criteria (specific symptoms, medications, previous diagnosis, and physical findings) had to be satisfied to be able to undergo a SST. Additionally, we noticed that a number of patients were probably being over-diagnosed wth adrenal insufficiency (AI) based on a single 30 min co...

Steroid replacement is life-saving in patients with steroid axis deficiency; education surrounding steroid replacement is vital in their management.We organised ‘Steroid Replacement Education Days’ for patients and their family members/carers to help enhance their knowledge on steroids and intercurrent illness. Lectures detailed manifestations, causes, management of steroid deficiency and the practical issues surrounding steroid replacement. Th...

We conducted a retrospective notes analysis to determine the incidence, prevalence and predictive factors of idiopathic postprandial hypoglycaemia (IPH) in a population of 230 000 served by our Hospital.Using the Biochemistry Database all patients who had a 5-hour oral glucose tolerance test (OGTT) from 1995 to 2001 were identified, and their notes were reviewed. Demographic, clinical and biochemical data were recorded for each patient. The latter includ...

Introduction: Herein we provide clinical, biochemical, histological and radiological evidence of a rare case of a male patient who was diagnosed with pituitary macroadenoma (prolactinoma), phaeochromocytoma and a lung typical-carcinoid tumour on a background of SDH gene mutation encoding the succinate dehydrogenase enzyme.Presentation of case: A 42 year old male individual, was initially diagnosed with a pi...