Endocrine Abstracts

Case: A 44-year-old patient presented with symptoms of sweating, shaking and hunger, which were all eased by eating. Her symptoms were suggestive of hypoglycaemia, experienced predominantly 2-3 hours after meals. Hypoglycaemia was confirmed during these episodes. She had normal liver and renal function. There was no history of Diabetes Mellitus.Her symptoms improved slightly with measures of adjusting her diet but did not sett...

Hyponatremia is the commonest electrolyte abnormality presenting to Medical Admissions and when acute, severe and symptomatic, is associated with high mortality. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common underlying disorder in hospitalised patients with euvolaemic hyponatraemia and is a complication of many clinical conditions and drug therapies.We discuss the cases of two patients...

We present this 62-year-old man with a background of Marfan’s Syndrome, aortic valve replacement, atrial fibrillation and asthma who presented with increasingly severe episodic hypoglycaemia over a period of 22 years. Of note he was not diabetic and was not on any hypoglycaemia-inducing medications. Extensive investigations included the following: 72 hr fast, 5 hr OGTT, continuous glucose monitoring, basic biochemistry, hormone profiles (GH, LH...

Serum alkaline phophatase (ALP) may be released from various sources, including liver, bone, thyroid, intestine and placenta. Herein, we describe a rare case of an isolated serum ALP rise initially dismissed, and later resulting in an incidental finding of a mediastinal seminoma.A 56-year-old gentleman was referred to the Endocrinology Outpatients by his general practitioner, with a 1-month history of presumed post-viral fatig...

Introduction: Single-electrolyte derangement is a common biochemical finding. Multiple-electrolytes derangement is less common and require multiple and simultaneous corrective therapies. We present a patient who had multiple admissions with multiple-electrolytes derangement, which after further evaluation required a single therapeutic intervention.Case: A 26-year-old lady had eight admissions over three years with abdominal pain and vomiting. During each...

Background: Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is an autosomal recessive inherited disorder resulting in the inability to breakdown medium-chain fatty acids to provide energy during periods of low-calorie intake and hypoglycaemia (infections, fasting, vomiting). Without urgent treatment, the accumulation of toxic fatty acids leads to encephalopathy and sudden death.Pregnant females with Type 1 diabetes requ...

Homocystinuria is a rare autosomal recessive disorder of the transsulfuration or methylation pathway in methionine metabolism.We present a case of a 25 years old female, who presented with rapid onset loss of vision in both eyes and short-sightedness. She had a background of well-controlled epilepsy, normal mental and physical development. She had no family history of Marfan’s syndrome.On examinatio...

Background: Hyponatraemia is the commonest electrolyte abnormality. It carries a mortality rate of above 50% when plasma sodium concentration falls below 115 mmol/L. We present a case of severe hyponatraemia complicating pre-eclampsia in a primiparous woman.Case Report: A 23-year old healthy primigravida was admitted at 34 weeks’ gestation following an episode of reduced foetal movements. She was hypertensive (BP 171/98 m...

Background: An 88 year old gentleman was referred to the endocrine team as an inpatient with recurrent episodes of spontaneous hypoglycaemia. These occurred in the early hours of the morning when he was found to be unrousable from sleep. There was no background history of diabetes. He was under the oncology team on this admission with pyrexia post-palliative chemotherapy with trabecitidine. Significant past medical history include metastatic solitar...

Diabetic ketoacidosis and pregnancy related ketoacidosis are the most common forms of ketoacidosis seen in acute medical units. We describe here two rare cases of starvation ketoacidosis.Case 1: 63 years old gentleman with no history of diabetes, presented with persistent vomiting for 48 hours. His admission bloods revealed Serum Bicarbonate of 8, pH 7.19, pCO2 2.7, base excess of -17.8, plasma glucose 5.2 mmol/l and serum alc...

A 41 year old Emirati man was reviewed in January 2016 for hypercholesterolaemia managed on diet alone, but direct questioning revealed gradual onset erectile dysfunction over 2 years, treated by a urologist elsewhere. Initial response to Cialis had waned over 18 months. Testosterone replacement (Nebido) had been initiated in June 2015 on the basis of one low morning total testosterone of 3.89 nmol/L (normal range 8.64 – 29). SHBG and prolactin...