Endocrine Abstracts

A 26 year old lady presented with a 4/12 history of abdominal distension and lethargy. PMH included learning difficulties and congenital hypotonia and she was in long-term foster care.Diabetes had been diagnosed requiring insulin a few months previously. Examination revealed her to be extremely unwell, with proximal myopathy, purple striae, hirsutism and a firm nodular thyroid gland. She was hypokalaemic (2.8 mmol/l) and alkalotic. Cushing’s assessment(table) revealed ACT...

A 17 year old girl was referred to us from the gynaecology department with history of primary amenorrhea. She was otherwise well and previous medical history included severe acne requiring referral to ENT, plastic surgery and dermatology services at age 13 and hirsutism for which she had privately funded laser treatment. On examination she had acanthosis nigricans and BMI of 22 but was virilised with clitoromegaly, hypertrophied labia majora and hirsuitism. Pelvic ultrasound r...

Back ground: Acute adrenal insufficiency is a life threatening condition with multiple aetiologies. The adrenal gland is susceptible to thrombosis and hemorrhagic infarction due to rich arterial supply and limited venous drainage. We present a case report of a simultaneously detected acute adrenal insufficiency due to bilateral adrenal haemorrhagic infarcts with ischemic bowel as the first manifestation of antiphospholipid syndrome (APS).Case history: A ...

Agranulocytosis is a well recognised but rare side effect of carbimazole therapy which usually occurs within the first 3 months of treatment .We report the case of a 55 year old woman with Graves disease, who developed delayed carbimazole induced agranulocytosis, precipitating a thyroid crisis.Our patient presented with clinical and biochemical evidence of hyperthyroidism in 1998. She was treated with carbimazole and thyroxine in a standard block and replace regimen, this was ...

Case history: An 81 years old lady with treated follicular lymphoma, hypertension and osteoporosis was admitted to hospital with a fall and was found to have hypercalcaemia with adjusted calcium of 4.9 mmol/l (nr 2.2–2.6 mmol/l). There was history of constipation but no history of excessive thirst or polyuria. The patient was on atorvastatin, amlodipine, bendroflumethiazide, ramipril, calcium and vitamin D. On examination our patient was dehydrated and mildly confused. There w...

We present the case history of a 62 year old male, who was recently diagnosed with sarcoidosis which was confirmed on biopsy of a calf nodule. CT scan revealed pulmonary involvement. Our patient had low vitamin D 12 nmol/l (nr 50–100) and initial adjusted calcium was 2.48 mmol/l (2.13–2.63). DEXA bone density scan revealed osteopenia. He was commenced on loading dose of colecalciferol 40,000 units weekly and received 3 doses. He presented 1 month later with polydipsi...

Introduction: Brown tumours (BT) are a recognised complication of severe prolonged untreated hyperparathyroidism (HPT). BT can mimic bone metastases and giant cell tumors (GCT). Hungry bone syndrome (HBS) is a severe and prolonged, postoperative hypocalcemia following parathyroidectomy. BT are a risk factor for HBS. We report the case of a young lady with BT masquerading as a GCT, from a tertiary centre in India.Case study: A 25 year lady presented with ...

Background: As adoption of continuous glucose monitoring (CGM) continues to expand, lot more studies are investigating the effects of CGM on HbA1C and hypoglycaemia risks in people with Diabetes Mellitus (PwD). In PwD, established benefits of usage of CGM along with digital diabetes self-management and education (DSME) program in Indian real-world context are scarce. OneCare compares patients engaged in its “IMPACT’ DSME program alone vs program assisted by CGM.<...

A 45-year-old man with obesity (BMI 36 kg/m2) was admitted with a 12-hour history of headache and confusion and managed for viral meningitis. Treatment was discontinued after CSF viral PCR was negative. At presentation, he was hypoglycaemic with a capillary glucose of 1.6 mmol/l. Past medical history was not significant and there were no similar episodes previously. He denied taking insulin, other medications, illicit drugs or alcohol. Initial investigations reveale...

A 32-year-old man presented with a four year history of reduced libido, erectile dysfunction and inability to conceive with his partner. He went through puberty normally and had a normal sense of smell. Clinical examination revealed that he was 205 cm tall and normally virilised. Testicular volume was reduced, but the phallus was normal. Clinically, he appeared euthyroid and there were no features of hypercortisolism or growth hormone excess. Biochemical picture: prolactin 375...