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Endocrinology 2018
Journal of Clinical and Molecular Endocrinology
ISSN: 2572-5432
Page 46
August 09-10, 2018
Madrid, Spain
11
th
International Conference on
Endocrinology and
Diabetology
A
68 year old female with known history of hypertension and
recent onset Type 2 Diabetes Mellitus requiring Insulin
therapy, was referred for cellulitis of hand/forearm which did not
respond to Intravenous antibiotics. She subsequently developed
an abscess in this region which was successfully drained.
Following the surgery she developed hypokalaemia in the range
of 1.9-2.8 mmol/L which was refractory to treatment. Her serum
magnesium was normal. She was Hypertensive with systolic
Blood pressure around the 150 mark. On examination, she had
central obesity and proximal myopathy with thin and easily
bruisable skin of recent onset. Striae noted in the abdomen. Her
24 hour urinary free cortisol was found to be grossly elevated
at 4626 nmol/24 hour. ACTH was 154 ng/L. Urinary potassium
was 70mmol/L. A CT thorax, abdomen and pelvis excluded
an ectopic ACTH secreting source. MRI of her pituitary gland
revealed a macroadenoma invading the right cavernous sinus
and protruding into the right sphenoid sinus. the pituitary was
operated on. Postoperative 24 hour urinary free cortisol fell to
107 nmol/24 hour, ACTH level to 18 ng/L, serum cortisol level
of 206nmol/L with the normalization of the potassium level. The
Histology of the pituitary mass revealed an adenoma with ACTH
and GH expression. Surgery in this case led to improvement in
blood pressure and glycaemic control together with complete
resolution of hypokalaemia. Cortisol excess due to Cushing’s
disease should be considered in the investigation of patients with
refractory hypokalaemia in a suggestive clinical context.
Biography
Dr Najeeb Shah is specialist registrar in endocrinology , Dr Ali Ahmed is a
specialist registrar at Hull royal infirmary, Dr R.Karim is specialist registrar
in endocrinology , Dr Kmarudeen Mohammed is senior endocrinology and
honorary lecturer at HYMS university , he also the programmer director of
the endocrinology training at Yorkshire deanery in UK ..
Najeeb_shah01@hotmail.comACUTE PRESENTATION OF CUSHING’S DISEASE WITH REFRACTORY
HYPOKALEMIA PITUITARY MACROADENOMA ON MRI
N.Z Shah, R. Karim, A.Ahmed
and
K.Mohammed
Centre of endocrinology Hull royal infirmary ,Hull HU3 2JZ ,UK
N.Z Shah et al., J Clin Mol Endocrinol 2018, Volume 3
DOI: 10.21767/2572-5432-C2-006