Endocrine Abstracts

A 76-year-old man with history of oesophageal carcinoma was successfully treated by surgery and radiotherapy 4 years previously. He presented with anorexia and 4 stones weight loss associated with abdominal discomfort. He was not on any medication. On examination blood pressure 100/60, no peripheral oedema, systemic examination otherwise was unremarkable. Soon after admission, he developed a generalised tonic clonic seizure requiring a Lorazepam and Phenytoin infusion to contr...

A 59-year-old Caucasian heterosexual man presented with malaise and dizziness. General examination revealed no peripheral oedema, no clubbing or lymphadenopathy and systemic examination was otherwise normal. His initial investigations showed hyponatremia with serum sodium 121 mmol/l, potassium 3.4 mmol/, serum osmolality 255 mOsml/kg, and urine osmolality 672 mOsml/kg. The rest of blood tests including; thyroid function, short Synacthen test, full blood count, liver functions,...

A 58-year-old previously fit and well man presented with sudden onset severe epigastric pain associated with frequent episodes of vomiting. The pain was constant and relieved only with morphine. He was febrile otherwise systemic examination was normal. Serum sodium 132 mmol/l and serum potassium 4.4 mmol/l. The rest of blood testes including; full blood count, liver functions, glucose, amylase, corrected calcium, D-dimer, troponin, urea and creatinine were all normal. ECG, che...

Background: Lung cancers are one of the leading causes of death worldwide which has resulted in an increase in immunotherapy, particularly immune checkpoint inhibitors (ICIs). Recent studies have shown induced endocrinopathies secondary to ICIs as a result of pancreatic beta cells, thyroid, and pituitary dysfunction.Aim: We aim to present an interesting case of Type 1 Diabetes mellitus secondary to immunotherapy. Pembrolizumab is used to treat melanoma, ...

A 74-year-old male presented to hospital following an episode of brief loss of consciousness and several hours of post ictal confusion. There was no witnessed seizure activity, tongue biting, or incontinence. His past medical history included SCC right scalp, TIA and primary hypothyroidism. He had been commenced on Cemiplimab (immunotherapy) for metastatic SCC seven months before. On assessment, he appeared well and general examination including neurological examination was no...

Introduction: Acute pancreatitis is an inflammatory disease of the pancreas that can lead to necrosis of the pancreas and if infected could lead to multi-organ failure. Common cause of acute pancreatitis are gallstones and excess alcohol consumption. Hypertriglyceridemia is becoming an increasing cause of acute pancreatitis and is diagnosed with serum triglyceride levels >1.7 mmol/l. It is associated with high morbidity and mortality.Case presentatio...

Introduction: Pituitary adenomas are benign tumours of the pituitary gland with an estimated prevalence rate of approximately 17%. Around 1 in 600 people have macroadenoma (>1cm) that can present with variety of visual problems classically as bitemporal hemianopia due to compression of the optic chiasm.Case presentation: 50-year-old male was admitted with 3months history of worsening headache and 4months of visual disturbances. Initially he was seen ...

Background and aims: Statins has long been used as first line treatment option for hypercholesterolemia however; half of population doesn’t achieve target LDL reduction. Proprotein convertase subtilisin kexin 9 inhibitors (PCSK9i) are a promising addition to anti-dyslipidemic armamentarium. Aim of this study is to find out the efficacy of PCSK9 inhibitors in a district general hospital of Northwest of England.Method: We identified all the patient wh...

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...