Endocrine Abstracts

Introduction: Autoimmune disorders are known to be more frequent in women and often associated each others, but it is rare to see multiple autoimmune diseases in a single patient. Multiple autoimmune syndrome (MAS) is defined as the combination of at least three autoimmune diseases in the same patient. The pathogenesis of MAS is not known. Genetic, infectious, immunologic and psychological factors have all been implicated in its development.Observations:...

We report the case of a 14-year-old female patient with β-thalassemia major (β-TM) that presented numerous endocrine complications following bone marrow transplantion (BMT). The patient was admitted in our department for endocrine evaluation 3 years after BMT. She was diagnosed with β-TM at 1 year of age and received chronic blood transfusions and oral chelating therapy until 2012 when BMT was performed. The patient developed acute skin and intestine graft-versu...

Introduction: Immunologic background often present different association of two or more autoimmune diseases. However the coexistence of Basedow disease (BD) – the prototype of these disorders - with pernicious anemia (PA), sometimes as a component of pancytopenia, is rarely described. Between 50 patients operated on immunologic hyperthyroidism in a 20 years period only one case related this uncommon combination.Case report: AB, a 46-year-old woman w...

Introduction: Hyponatremia (defined as a serum sodium level <135 mmol/l), is seen in in 15–30% in hospital setting, especially in intensive care units. Certain drugs (e.g.Thiazides diuretics) used in everyday clinical practice, may induce hyponatremia, more frequently in elder women.Case report: A 76-year-old woman presented at emergency unit with complaints: physical weakness, nausea, vomiting, extreme fatigue and abdominal pain. She was under ...

Polycystic ovarian syndrome presents in 4–8% of women worldwide, making it the most common reproductive age endocrinopathy. Rheumatological concomitant diseases are extremely rare in PCOS patients, especially Raynaud’s phenomenon. Condition that, lowers the quality of life in patients, suggesting hormonal imbalances despite years of treatment. Studies show that oestrogen plays a role in the vasculature, it is exogenous administration increases the endothelium depende...

The term polyglandular autoimmune syndrome (PAS) is used when there is a dysfunction of two or more endocrine glands associated with circulating antibodies directed at organspecific included glands. Neufeld and Blizzard classified PAS into two categories: type I and type II with the newly added category, type III, which does not include the adrenal cortex. PAS III includes several autoimmune diseases (autoimmune thyroiditis, immune-mediated diabetes mellitus, pernicious anemia...

A 58-year-old male was admitted through the emergency department with symptomatic severe euvolemic hyponatremia. Biochemistry was consistent with SIAD (plasma sodium (pNa) 107 mmol/l, plasma osmolality 230 mOsm/kg, urine sodium 36 mmol/l, urine osmolality (UOsm) 638 mOsm/kg, 0900 h plasma cortisol 484 nmol/l and thyroid function tests normal). Chest X-ray was normal but CT thorax confirmed a lung mass suspicious for malignancy. As the patient had symptoms of cerebral irritatio...

Glycosylated haemoglobin (HbA1c) is considered the Gold Standard parameter for evaluating long-term glycemic control in individuals with Diabetes Mellitus (DM). The presence of hemoglobin variants or others conditions that modify its glycosylation, can affect the veracity of its measurement. The detection of these hemoglobinopathies and his knowledge by the clinicians is very important for the correct diagnosis and follow-up. We present the case of a patient who presented a he...

Introduction: Multiple autoimmune syndrome (MAS) is a rare condition, first described by Humbert and Dupond in 1988 and characterised by three or more autoimmune disorders in the same individual.Case description: Here we present a case of 14-year-old female patient diagnosed with ocular myasthenia gravis. The diagnosis of Graves’ disease was suspected on the basis of hyperthyroidism symptoms and confirmed by undetectable TSH level (<0.01 mUI/l) ...

Introduction: Asplenia has been reported in 10% of patients with type 1 APS (APS-1), but has never been reported in APS-2. We describe a patient with presumed APS-2 and aplenia.Case report: A 69-year-old woman was diagnosed with B12 deficiency with severe anemia at age 21 and insulin dependent diabetes mellitus at age 33, following routine testing. At 59, she was hospitalized with salt wasting and a diagnosis of Addison’s disease was made, which was...

Introduction: Immune checkpoint inhibitors (ICPIs) are recent approved drugs used in malignant melanoma, non-small-cell lung cancer and renal cell cancer. They act by activating host T cell against malignant antigens. Immune checkpoint blockade can lead to breaking of immune self-tolerance, thereby inducing autoimmune/autoinflammatory side effects, such as endocrinopathies. It may affect thyroid, adrenal and pituitary. We present two ICPIs induced thyroiditis cases.<p clas...

Background: Nivolumab is a monoclonal antibody specific for human PD-1 (programmed cell death protein-1), a checkpoint molecule highly expressed in several cancers. Nivolumab is an immunotherapeutic strategy for human cancer, but it can interfere with endocrine system.Case reports: We report four cases regarding nivolumab-associated endocrinopathies: (i) Male, 55-year-old, with previous normal cortisol and adrenocorticotropic hormone (ACTH) levels, treat...

Introduction: Meigs’ syndrome is defined as the presence of a benign ovarian tumour (fibroma), in association with ascites and hydrothorax. The characteristic feature of this condition is the resolution of the effusions once the tumour is surgically removed.Case report: A 63 year-old female patient was admitted to the Surgery Clinic with metroragia, abdominal distention, and a recent history of minor breath shortness. Pulmonary clinical examination ...