Endocrine Abstracts

29-year old woman was admitted with tetany & severe hypocalcaemia despite treatment with high dose alpha-calcidiol (6 micrograms/day) and Calcium (8.0 g/day).PMH: Six years previously she had subtotal thyroidectomy for non-toxic goitre in another Department. Postoperatively she required Thyroxine, but was lost to formal endocrine follow-up. Five years later she presented with abdominal discomfort and occasional diarrhoea. Investigations performed by ...

A 71 year old woman presented to neurologist with taste disturbance, tingling and stabbing pains across the face. Examination, blood tests and MRI scan of the brain were normal. Later that year she lost considerable amount of hair, developed severe onycholysis, nausea and loose stools. Weight started to decline and skin became darker. Endocrine referral was made.On examination she had titubation, partial alopecia and severe onycholysis. BP 140/80 mm Hg, ...

A 22 year old student sought medical attention with a month's complaint of intermittent tingling and spasms in his hands and in the last week more difficulty with phonation. He had previously been fit and active except in his neonatal period. He was a 6 weeks premature 'blue baby' and was transfused 6 times in his first week of life and received anti-D antibodies. He had mild asthma from age 2 but this no longer troubles him. He had been an otherwise fit student playing footba...

Background: ACTH concentrations remain typically elevated in patients with Addison’s disease. We present a case of an extremely potent oral contraceptive pill (OCP) induced increase in total cortisol resulting in inhibition of ACTH secretion that was normalized on OCP withdrawal.Case Presentation: A 20-year old female was diagnosed with Addison’s disease [cortisol 1.59 µg/dl, ACTH>500 pg/ml (0-65)] and...

Background: Amiodarone-induced thyrotoxicosis (AIT) is sometimes very difficult to treat. Pulse methylprednisolone in addition to oral steroids appears effective in treatment of AIT, but effects of such treatment may be transient.Presentation of The Case: A 65 year old man was admitted our Department because of drug-resistant AIT. He had a history of atrial fibrillation, treated with amiodarone since 2019, and NSTEMI myo...

Background: Amiodarone-induced thyrotoxicosis is sometimes extremely difficult to treat necessitating emergency thyroidectomy with perioperative risks including possible thyroid storm. We obtained near normalization of free T3 (FT3) by pulse Methylprednisolone prior to thyroidectomy for drug-resistant Amiodarone-induced thyrotoxicosis.Case Description: A 56 year old man (BMI 29.7 kg/m2), with history atrial flutter/fibrillation, episodes of fa...

Background: Vasopressin, secreted in equimolar amounts with copeptin, is implicated as a stimulus for ACTH secretion during dynamic tests, such as Glucagon Stimulation Test (GST) or Insulin Tolerance Test (ITT). Some individuals with intact ACTH-cortisol axis, demonstrate, however, a lack of further cortisol stimulation during GST. We have assessed whether failure of further ACTH-cortisol increase during GST may be associated with an inadequate vasopressin/copeptin release.</p...

Background: Self-administration of anabolic steroids among bodybuilders is an underestimated problem, often not admitted by patients.Case presentaation: A 19 year old male (planning to study medicine!) presented with gynaecomastia, general malaise and erectile problems. Investigations revealed acute hepatitis: ALT 2125 U/L [Ref. range (RR)<45] and hypogonadotropic hypogonadism: LH – 1.6 IU/L [RR: 1.5-9.3], testosterone 0.214 ng/mL [RR: 2.49-8.36...

Background: Neck irradiadion is associated with several complications including both hypo- and hyperthyroidism. We present a case of severe hypothyroidism, followed 5 years later by thyrotoxicosis.Case description: A 27-year-old female presented with clinical and biochemical thyrotoxicosis (TSH 0.01 μIU/ml (ref. range: 0.27–4.2 μIU/ml); FreeT4 1.58 ng/dl (ref. 0.98–1.63 ng/dl); FreeT3 4.56 pg/ml (ref. 2.6–4....

Background: Hyperthyroidism is a common endocrine disorder that is linked to increased cardiovascular morbidity and mortality. Thrombospondin, the matricellular protein, is an important player in the process of cardiac remodelling with complex effects on cardiovascular disease (e.g. prothrombotic and antiangiogenic effects vs potential protective effects in heart failure). Adiponectin is an adipose tissue-derived hormone that shows beneficial effects on atherogenesis, endothel...