Diagnostic Challenges in a Case of Refractory Severe Hypercalcemia Due to Splenic Sarcoidosis.

Hypercalcemia is frequently encountered in clinical practice; however, sarcoidosis-induced hypercalcemia is relatively uncommon and requires careful evaluation, particularly when initial investigations are inconclusive or the hypercalcemia is refractory to standard treatment. We present a complex case of a 60-year-old female with chronic stage IV diabetic nephropathy who presented with acute severe asymptomatic hypercalcemia resulting from splenic sarcoidosis confirmed on splenic biopsy. Despite commencement of prednisone therapy, her hypercalcemia persisted.

Severe Overt Hypothyroidism-Induced Rhabdomyolysis Complicated by Acute Renal Impairment.

Musculoskeletal symptoms in hypothyroidism are often vague and non-specific, but in rare cases, rhabdomyolysis may develop as a serious complication. Here, we report a case of a 25-year-old man with a known history of Hashimoto's thyroiditis who presented with symptoms of rhabdomyolysis complicated by renal impairment secondary to severe overt hypothyroidism in the context of medication non-compliance. He presented with symptoms of generalised myalgia and fatigue.

Assessing the impact of a dedicated referral and management algorithm in maternal hypothyroidism.

Background: The significant risks of hypothyroidism during pregnancy can be mitigated through timely diagnosis and initiation of thyroxine to achieve a maternal euthyroid state. This study aimed to evaluate the efficiency of hospital endocrine services by assessing the rate of thyroxine commencement before the initial clinic appointment, the median gestational age at the first consultation, the rate of guideline-appropriate investigations, perinatal outcomes, and the proportion of referred patients who achieved their target thyroid-stimulating hormone (TSH) levels before and after implementing a dedicated referral and management pathway.

Methods: A retrospective clinical audit was conducted using electronic medical records for the first fifty consecutive patients with hypothyroidism referred to the hospital clinic during two-time intervals: from April 1 to September 1, 2020 (pre-intervention) and from April 1 to September 1, 2021 (postintervention).