Endocrine Abstracts

Diabetes can manifest not only with hyperglycemia,but also as hypoglycemia. It typically occurs postprandially,3-5 hrs after meals and is preceded by early post meals hyperglycemia.58 yrs old Saudi gentleman had Type 2 diabetes for 5 yrs,dyslipidemia,Mitral valve disease,Bronchial asthma, GERD,vitamin D deficiency,BPH and depressive illness. He had presented to the outpatient Diabetes clinic in November, 2015 with post-p...

A 51 year old female patient presented in 2000 with a 7 month history of diarrhoea and weight loss. Bloods revealed hypokalaemia (1.9). Infection and malabsorption screen negative, but patient remained hypokalaemic despite maximum iv and oral replacement. No abnormality was found endoscopically. Fasting gut hormone profile showed raised Vasoactive Intestinal Polypeptide (VIP) >400 (NR <30). CT scan confirmed 5cm mass in body of pancreas, no metastatic disease. Response...

A 54-year-old man with a recurrent non-functioning pituitary gonadotroph adenoma previously treated with transphenoidal surgery (TSS) in 2015, presented to Charing Cross hospital for repeat transsphenoidal surgery in May 2022. Since his initial surgery, he remained on Levothyroxine 50 μg once daily only. There was no evidence of adrenal insufficiency (0900 h cortisol 333 nmol/l at day 6 following initial TSS). In February 2022, his electrolytes, FSH, LH, testosterone, pro...

A 30-year-old lady was initially seen in our clinic with a slight elevated corrected calcium with an elevated parathyroid hormone in March 2021. The elevated calcium [2.58mmol/l(NR: 2.10-2.55)] was first noted in 2018 when she had investigations for easy bruising, fatigue, breathlessness, and weight loss. The symptoms settled on their own and her calcium levels were monitored routinely. She was referred to our clinic when the corrected calcium had increased to 2.69mmol/lwith a...

Background: Pheochromocytoma is a rare tumour that arise from chromaffin cells in the adrenal medulla and produces signs and symptoms due to excessive catecholamine secretion from tumour. Presenting symptoms can vary but often they classically present with headaches, sweating and palpitations in the setting of paroxysmal hypertension. Pheochromocytoma crisis results from the sudden release of large quantities of catecholamines and leads to progressive multiple organ dysfunctio...

Case history: A 33 year old lady with irregular menstrual cycles and infertility presented to gynaecologist with recurrent abdominal pain and bloating. Her pain was found secondary to bilateral ovarian cysts. She had repeated laparoscopic ovarian cystectomies since 2018. In December 2021, modest hyperprolactinemia (1065MIU/L, RR 102-496) with negative macroprolactin test was noted, and MRI pituitary revealed 18x17x13mm pituitary macroadenoma. Cabergoline was started and she wa...

Case history: A 63-year-old female was admitted to our hospital in January 2022 with neck swelling that had developed over five days with associated dysphagia to fluids. Biochemistry revealed severe hypercalcaemia with a corrected calcium of 3.82 mmol/l (2.20 - 2.60 mmol/l) and PTH of 78.7 pmol/l (1.6 - 6.9 pmol/l), and an associated AKI (creatinine of 174 umol/L from a baseline of 80). Ultrasound initially showed a left-sided 3 x 2 cm nodule suggestive of a large parathyroid ...

Section 1: Case history: Adrenal haemorrhage in pregnancy is rare but life threatening. We present the case of a 23-year-old woman who developed idiopathic spontaneous bilateral adrenal haemorrhages during pregnancy. The patient, without significant past medical history, presented at 35 weeks of gestation with right sided lower thoracic and abdominal pain which was thought to be musculoskeletal in nature; she was discharged home once the pain settled. She represented at 37 wee...

Case history: A 65 year-old Caucasian gentleman was admitted with out-of-hospital VF arrest at work place. ROSC was achieved after shock by paramedics but developed multiple in-hospital arrests requiring (>100 shocks in 24 h) with incessant polymorphic ventricular tachycardia which was resistant to anti-arrhythmic therapy including drugs and pacing. Investigations revealed hypercalcemia and newly diagnosed high PTH with no change in mild LV dysfunction from previous myocardial...

Case presentation: A 66 year old male presented to the clinical physiology department for a routine ECHO. He was found to be hemodynamically unstable with fast Atrial fibrillation and was referred to ED for immediate management. He was subsequently admitted in CCU under Cardiology. He presented with a 3 month history of shortness of breath, palpitations, persistent tremors, unintentional weight loss and generalised fatigue. No previous thyroid problems. He had a longstanding h...