Transient diabetes insipidus in pregnancy.
Abstract
UNLABELLED: Gestational diabetes insipidus (DI) is a rare complication of pregnancy, usually developing in the third trimester and remitting spontaneously 4-6 weeks post-partum. It is mainly caused by excessive vasopressinase activity, an enzyme expressed by placental trophoblasts which metabolises arginine vasopressin (AVP). Its diagnosis is challenging, and the treatment requires desmopressin. A 38-year-old Chinese woman was referred in the 37th week of her first single-gestation due to polyuria, nocturia and polydipsia. She was known to have gestational diabetes mellitus diagnosed in the second...
Source: Diabetes Metab - November 4, 2015 Category: Endocrinology Authors: Marques P, Gunawardana K, Grossman A Tags: Endocrinol Diabetes Metab Case Rep Source Type: research
Iatrogenic myxoedema madness following radioactive iodine ablation for Graves' disease, with a concurrent diagnosis of primary hyperaldosteronism.
We present the first reported case of iatrogenic myxoedema madness following radioactive iodine ablation for Graves' disease, with a second concurrent diagnosis of primary hyperaldosteronism. A 29-year-old woman presented with severe hypothyroidism, a 1-week history of psychotic behaviour and paranoid delusions 3 months after treatment with radioactive iodine ablation for Graves' disease. Her psychiatric symptoms abated with levothyroxine replacement. She was concurrently found to be hypertensive and hypokalemic. Primary hyperaldosteronism from bilateral adrenal hyperplasia was diagnosed. This case report serves as a remin...
Source: Diabetes Metab - November 4, 2015 Category: Endocrinology Authors: Larouche V, Snell L, Morris DV Tags: Endocrinol Diabetes Metab Case Rep Source Type: research
Cushing's storm secondary to a rare case of ectopic ACTH secreting metastatic breast cancer.
We report a case of a 30-year-old woman with a history of breast cancer, who presented with psychosis and paranoid behaviour. CT of the head showed white matter disease consistent with posterior reversible encephalopathy syndrome (PRES). Despite using mifepristone with multiple antihypertensives including lisinopril, spironolactone and metoprolol, she was hypertensive. Transaminitis did not allow mifepristone dose escalation and ketoconazole utilization. Etomidate infusion at a non-sedating dose in the intensive care unit controlled her hypertension and cortisol levels. She was transitioned to metyrapone and spironolactone...
Source: Diabetes Metab - November 4, 2015 Category: Endocrinology Authors: Bucciarelli M, Lee YY, Magaji V Tags: Endocrinol Diabetes Metab Case Rep Source Type: research
A Greek girl with 11β-hydroxylase deficiency due to compound heterozygosity for two novel mutations in CYP11B1 gene.
Abstract
UNLABELLED: 11β-hydroxylase deficiency (11β-OHD), an autosomal recessive inherited disorder, accounts for 5-8% of congenital adrenal hyperplasia. In Greece, no cases of 11β-OHD have been described so far. The patient presented at the age of 13 months with mild virilization of external genitalia and pubic hair development since the age of 3 months. Hormonal profile showed elevated 11-deoxycortisol, adrenal androgens and ACTH levels. ACTH stimulation test was compatible with 11β-OHD. DNA of the proband and her parents was isolated and genotyped for CYP11B1 gene coding cytochrome P450c11. The gir...
Source: Diabetes Metab - November 4, 2015 Category: Endocrinology Authors: Marakaki C, Papadopoulou A, Karapanou O, Papadimitriou DT, Kleanthous K, Papadimitriou A Tags: Endocrinol Diabetes Metab Case Rep Source Type: research
Persistent syndrome of inappropriate antidiuretic hormone secretion following traumatic brain injury.
Abstract
UNLABELLED: The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can occur following traumatic brain injury (TBI), but is usually transient. There are very few case reports describing chronic SIADH and all resolved within 12 months, except for one case complicated by meningo-encephalitis. Persistent symptomatic hyponatremia due to chronic SIADH was present for 4 years following a TBI in a previously well 32-year-old man. Hyponatremia consistent with SIADH initially occurred in the immediate period following a high-speed motorbike accident in 2010. There were associated complication...
Source: Diabetes Metab - November 4, 2015 Category: Endocrinology Authors: Dick M, Catford SR, Kumareswaran K, Hamblin PS, Topliss DJ Tags: Endocrinol Diabetes Metab Case Rep Source Type: research
Resistant hypertension with adrenal nodule: are we removing the right gland?
We describe the case of an elderly gentleman who presented with severe and resistant hypertension and was found to have a left adrenal incidentaloma during evaluation but had aldosterone excess secondary to unilateral adrenal hyperplasia (UAH) of the contralateral gland, which needed surgical intervention. A 65-year-old gentleman was evaluated for uncontrolled high blood pressure (BP) in spite of taking four antihypertensive medications. The high BP was confirmed on a 24-h ambulatory reading, and further biochemical evaluation showed an elevated serum aldosterone renin ratio (ARR) (1577 pmol/l per ng per ml per h). Radio...
Source: Diabetes Metab - November 4, 2015 Category: Endocrinology Authors: Das G, Taylor PN, Tabasum A, Rao Bondugulapati LN, Parker D, Baglioni P, Okosieme OE, Scott Coombes D Tags: Endocrinol Diabetes Metab Case Rep Source Type: research
Giant myelolipomas and inadvertent bilateral adrenalectomy in classic congenital adrenal hyperplasia.
We report a case of a 51-year-old man with classic salt-wasting CAH managed on prednisone 7.5 mg daily and fludrocortisone who presented with chronic back pain and was found to have giant bilateral retroperitoneal masses. On computed tomography (CT) imaging, the masses were heterogeneous, but contained predominantly low-density fat attenuation. The tumors were resected due to concern for malignancy and mass symptoms. Pathologic examination identified both retroperitoneal masses as myelolipomas. The left tumor was 34×20×13 cm and weighed 4.7 kg and the right tumor was 20 cm in the largest dimension. Adrenal tissue...
Source: Diabetes Metab - November 4, 2015 Category: Endocrinology Authors: Kale G, Pelley EM, Davis DB Tags: Endocrinol Diabetes Metab Case Rep Source Type: research
Rare association of insulin autoimmune syndrome with ankylosing spondylitis.
We describe a patient with hitherto an unreported association of IAS with ankylosing spondylitis. We have also performed and described a simplified method of polyethylene glycol (PEG) precipitation of an insulin bound antibody in the serum.
LEARNING POINTS: IAS should be considered in differential diagnosis of endogenous hyperinsulinemic hypoglycaemia.Ankylosing spondylitis can be associated with IAS apart from several other autoimmune diseases.Very high serum insulin levels (100-10 000 μU/ml) are frequently seen in IAS.When faced with very high serum insulin before suspecting insulinoma, it is advisable that ...
Source: Diabetes Metab - November 4, 2015 Category: Endocrinology Authors: Raizada N, Rahaman SH, Kandasamy D, Jyotsna VP Tags: Endocrinol Diabetes Metab Case Rep Source Type: research
Chinese Erdheim-Chester disease: clinical-pathology-PET/CT updates.
We reported a case of ECD and reviewed the clinical features of 13 cases of ECD reported so far in China. A 53-year-old male was diagnosed with central diabetes insipidus in March 2014, followed by fever, splenomegaly and anemia in July 2014. His initial pituitary magnetic resonance imaging (MRI) revealed the absence of high signal at T1-weighted image in posterior pituitary without any lesion. A further positron emission tomography/computer tomography (PET/CT) images showed elevated metabolic activity of (18)F-2-fluro-D-deoxy-glucose (FDG) and low (13)N-NH3 uptake in the posterior pituitary, and multi-organ involvement. B...
Source: Diabetes Metab - November 4, 2015 Category: Endocrinology Authors: Ding H, Li Y, Ruan C, Gao Y, Wang H, Zhang X, Liao Z Tags: Endocrinol Diabetes Metab Case Rep Source Type: research
Emerging utility of once-weekly exenatide in patients with type 2 diabetes.
Abstract
Type 2 diabetes mellitus (T2DM) is a major risk factor for the development of cardiovascular disease (CVD). Due to the ever increasing incidence of both T2DM and CVD and coexistence of these disorders, numerous agents have been developed over the years to target complications. We focus on the efficacy and safety perspective of a long-acting formulation of the glucagon-like peptide-1 analog exenatide. Our review focuses on the various landmark trials, efficacy, safety profile, and patient perspectives of weekly exenatide that delineates its current and future role in the treatment of patients with ...
Source: Diabetes Metab - November 4, 2015 Category: Endocrinology Authors: Goud A, Zhong J, Rajagopalan S Tags: Diabetes Metab Syndr Obes Source Type: research
Relating phthalate and BPA exposure to metabolism in peripubescence: The role of exposure timing, sex, and puberty.
CONCLUSIONS: Considering the long-term health effects related to metabolic syndrome, additional research on exposure and metabolic outcomes across developmental periods and early adulthood is needed.
PMID: 26529628 [PubMed - as supplied by publisher] (Source: Diabetes Metab)
Source: Diabetes Metab - November 3, 2015 Category: Endocrinology Authors: Watkins DJ, Peterson KE, Ferguson KK, Mercado-García A, Ortiz MT, Cantoral A, Meeker JD, Téllez-Rojo MM Tags: J Clin Endocrinol Metab Source Type: research
Differential Clinicopathological Risk and Prognosis of Major Papillary Thyroid Cancer Variants.
CONCLUSION: This large multicenter study demonstrates differential prognostic risks of the three major PTC variants and establishes a unique risk order of TCPTC > CPTC ≫ FVPTC, providing important clinical implications for specific variant-based management of PTC.
PMID: 26529630 [PubMed - as supplied by publisher] (Source: Diabetes Metab)
Source: Diabetes Metab - November 3, 2015 Category: Endocrinology Authors: Shi X, Liu R, Basolo F, Giannini R, Shen X, Teng D, Guan H, Shan Z, Teng W, Musholt TJ, Al-Kuraya K, Fugazzola L, Colombo C, Kebebew E, Jarzab B, Czarniecka A, Bendlova B, Sykorova V, Sobrinho-Simões M, Soares P, Kee Shong Y, Yong Kim T, Cheng S, Asa SL, Tags: J Clin Endocrinol Metab Source Type: research
A patient with novel mutations causing MEN1 and hereditary multiple osteochondroma.
In conclusion, we report novel mutations of the EXT1 and the MEN1 genes causing hereditary multiple osteochondromas and MEN1 in one patient.
LEARNING POINTS: It is important to ask for the patient's family history in detail.Patients with MEN1 are characterized by the occurrence of tumors in multiple endocrine tissues and nonendocrine tissues, most frequently parathyroid (95%), enteropancreatic neuroendocrine (50%), and anterior pituitary (40%) tissues.Familiar MEN1 has a high degree of penetrance (80-95%) by the age over 50; however, combinations of the tumors may be different in members of the same family.Patients...
Source: Diabetes Metab - November 2, 2015 Category: Endocrinology Authors: Remde H, Kaminsky E, Werner M, Quinkler M Tags: Endocrinol Diabetes Metab Case Rep Source Type: research
Low-calcium diet prevents fructose-induced hyperinsulinemia and ameliorates the response to glucose load in rats.
CONCLUSIONS: Low-calcium diet prevented fructose-induced hyperinsulinemia and improved glucose handling under conditions of fructose feeding. Potential mechanisms underlying these effects of the low-calcium diet remain to be determined, but possibilities include impairment of insulin release from the pancreas and improved peripheral insulin sensitivity.
PMID: 26516336 [PubMed] (Source: Diabetes Metab)
Source: Diabetes Metab - November 2, 2015 Category: Endocrinology Authors: Voznesenskaya A, Tordoff MG Tags: Nutr Metab (Lond) Source Type: research
Increased RhoA/Rho-Kinase Activity and Markers of Endothelial Dysfunction in Young Adult Subjects with Metabolic Syndrome.
CONCLUSIONS: Increased markers of cardiovascular risk are already present in young adults with metabolic syndrome but without type 2 diabetes or hypertension.
PMID: 26512756 [PubMed - in process] (Source: Diabetes Metab)
Source: Diabetes Metab - October 31, 2015 Category: Endocrinology Authors: Leguina-Ruzzi A, Pereira J, Pereira-Flores K, Valderas JP, Mezzano D, Velarde V, Sáez CG Tags: Metab Syndr Relat Disord Source Type: research
