Endocrine Abstracts

A 60 year old gentleman with a history of renal stones presented 5 years ago with left sided flank pain. A CT of his renal tract showed an unexpected metastatic deposit in the left iliac crest. Cross-sectional whole body imaging, performed to locate the primary, also identified an expansile soft tissue mass in the T8 vertebral body and a predominantly cystic looking left sided thyroid nodule. He proceeded to have an iliac crest biopsy which was consistent with metastatic folli...

Introduction: Prevalence of obesity is increasing worldwide. As a consequence the number of people undergoing bariatric surgery is also on the rise. Hypoglycaemia is increasingly seen in patients who have undergone gastric bypass surgery and we have successfully managed most of them. Here we describe our experience in dealing with one of the patients with disabling hypoglycaemia.Case-report: A 35-year-old woman with BMI of 41.87 kg/m2 had Roux...

Introduction: Primary hyperparathyroidism (PHPT) is an endocrine condition in which autonomous excessive secretion of parathyroid hormone (PTH) results in hypercalcaemia. In approximately 80% of cases the aetiology is due to a single parathyroid adenoma, the remainder are due to hyperplasia of more than one gland. Familial Hypocalciuric Hypercalcaemia (FHH) is an autosomal dominant, inactivating mutation of the calcium-sensing receptor, causing a right-shift in the concentrati...

Hypoparathyroidism is, in Italy, an orphan disease because the hormonal replacement therapy is possible only with teriparatide (fragment 1–34 of of human parathyroid hormone). Otherwise the patients use oral calcium and calcitriol. This scheme of therapy obtained correct plasmatic calcium and phosphate levels, correct urinary excretion of calcium and phosphate, adequate quality of life – QoL only in a little percentage of patients. Especially kidney stones, intra-ren...

Hypoparathyroidism (HypoPT) is the only hormone deficiency syndrome whose standard treatment is not based on the replacement of the missing hormone. Although most cases of postsurgical HypoPT can be effectively managed with the conventional use of oral calcium and active vitamin D (SOC therapy), some patients require very high doses and develop complications such as hypercalciuria, renal stones, nephrocalcinosis and ectopic calcifications. In the last few years, recombinant hu...

Introduction: Milk-alkali syndrome (MAS) consists of hypercalcemia, renal failure, and metabolic alkalosis as a result of ingestion of large amounts of calcium and absorbable alkali. Daily elemental calcium intake of no more than 2 g is considered safe. However, even doses lower than 2 g daily may result in hypercalcemia if additional predisposing factors are present. Vulnerable patients because of vomiting, diuretic use, and deviant eating habits. In these susceptible patient...

Introduction: Kallmann syndrome, a rare genetic disorder, refers to the association between hypogonadotropic hypogonadism and anosmia or hyposmia due to abnormal migration of olfactory axons and gonadotropin-releasing hormone producing neurons It can be autosomal dominant, autosomal recessive, or X-linked inheritance.Case report: A 16-year-old male student, presented to endocrinology unit with delayed puberty. He was born to consanguineous parents and ha...

Introduction: There is no consensus about the management of thymic enlargement in Graves’ disease (GD). If imaging indicates ‘benign’ thymic appearances, and interval scans are stable, most authorities advocate no intervention until thyrotoxicosis is controlled. We present 3 patients with GD and incidentally found thymic enlargement.Case presentations: a. A 37-year-old female presented acutely with osmotic symptoms, a weight ...

Introduction: There is no consensus about the management of thymic enlargement in Graves’ disease (GD). If imaging indicates ‘benign’ thymic appearances, and interval scans are stable, most authorities advocate no intervention until thyrotoxicosis is controlled. We present 3 patients with GD and incidentally found thymic enlargement.Case presentations: a. A 37-year-old female presented acutely with osmotic symptoms, a weight ...

History: A 52-year-old woman was referred by her GP for colonoscopy in view of 7 months” history of unexplained weight loss of nearly 2.5 stones, constipation and recently detected normocytic anaemia. Her past medical history was unremarkable except for bronchial asthma that was managed with albuterol. However, on the day of the scheduled colonoscopy, she was noted to be hypotensive (BP- 63/38 mm Hg, heart rate 93 bpm) and was hence admitted for fluid resuscitation. Follo...