Endocrine Abstracts

Tc- 99m Sestamibi parathyroid scan (SP scan) is performed to identify location of either hyperplastic or adenomatous gland(s) in primary hyperparathyroidism (HPT). In this study we evaluated diagnostic outcome in 55 consecutive patients with clinical diagnosis of HPT who were referred for SP scans and subsequently had parathyroid surgery. These patients with HPT were of 66.9+12.46 (mean + SD) age, and had serum calcium 10.9+0.93 mg/dl, phosphorus 3.0+0.51 mg/dl, chloride 107+3...

Case history: A 50-year-old lady, on Lithium for 30 years, presented with a history of progressively increasing thirst since 12 months; associated with polyuria and nocturia. She had been having some joint aches and was finding it more difficult to get up and down stairs. She was found to be hypothyroid few months back and prior to that had been falling asleep easily. There had been an improvement in her energy levels after starting Levothyroxine. She gave no history of renal ...

Case History: A 74-year-lady with a background of COPD presented to the emergency department with precordial chest pain radiating to the left arm. The pain had been ongoing since a few hours, and was associated with diaphoresis. She was hemodynamically stable, with no tachycardia Investigations: ECG showed significant ST-segment elevations, predominantly in the chest leads, with elevated troponins. Assuming it to be STEMI, she was transferred to the tert...

A 76-year-old lady with a background of Crohn’s disease (ileostomy in 1991) was referred to endocrinology in March 2022. Her 9-am cortisol level was <50 nmol/l, with a sodium of 130 mmol/l. These were done as she reported tiredness, lethargy and dizziness since November 2021. She had also lost 7 lb of weight. No evidence of hyperpigmentation. She had then been empirically started on hydrocortisone (10 mg-morning, 5 mg-afternoon and 5 mg-evening) pending evaluation of ...

Graves’ disease is a common autoimmune disease causing hyperthyroidism. Thyroid has a catabolic effect on carbohydrate metabolism especially in the hyperthyroid state. We describe a rare complication of thyrotoxicosis in a patient with type II diabetes on insulin, with no previous thyroid history. An 83 year old woman with type 2 diabetes on biphasic insulin presented with symptoms of polyuria, polydipsia and fatigue. She was tachycardic and tachypneic but normotensive an...

We report a case of a rare genetic condition of disordered bone turnover requiring complex multidisciplinary management.A 42-year-old lady presents with a 2-year history of worsening pain in both her legs and feet. She has a long standing history of structural equinus deformities worse on the right ankle and permanently walking on her toes. She also has fixed flexion deformities at both her knees. She normally is not able to weight bear and uses crutches...

Introduction: Osmotic demyelination syndrome (ODS) or commonly known as central pontine myelinolysis is commonly associated with rapid correction of hyponatraemia resulting in neurological deficits that manifests within days. The population commonly affected include alcohol dependence patients, the malnourished and liver failure patients. We describe a case of ODS developing in an alcoholic patient with symptoms developing 4 weeks after correcting hyponatraemia.<p class="a...

Graves’ disease is the most common cause of hyperthyroidism. It is well established that hyperthyroidism promotes a hypermetabolic state characterized by increased resting energy expenditure, increased lipolysis and gluconeogenesis. We describe a rare complication of thyrotoxicosis in a patient with type II diabetes on insulin, with no previous thyroid history. An 83 year old woman with type 2 diabetes on biphasic insulin presented with symptoms of polyuria, polydipsia a...

Patients with small bowel NET may present in a different way from other GPNET patients, with well-established disease and metastases. They may have long term symptoms that are well investigated but remain undiagnosed sometimes for years. To examine this supposition the presenting symptoms and outcomes of the first thirty patients with small bowel NET seen in 2018 were examined. Of these thirty patients eight were female and twenty-two were male with a median age of 64.5 years ...

Case: A 34-years-old male, construction worker, referred by GP with the history of vomiting, fatigue and near-collapse. Apart from alcohol excess, his past medical history was unremarkable. He did not have any personal or family history of any endocrinopathy, and was not taking any medication. Initial blood result were as below. ECG showed short QTc interval of 354 ms. His presentation was initially thought to be vomiting due to alcohol excess leading to dehydration and hyperc...