From hypomagnesaemia to Zollinger-Ellison syndrome: an adverse effect of a proton pump inhibitor.

We describe the case of a 53-year-old man who presented with abdominal pain, diarrhoea and hypomagnesaemia. The hypomagnesaemia proved to be due to gastrointestinal loss as urinary fractional excretion was very low, suggesting non-renal loss. Common causes were discarded and the hypomagnesaemia was attributed to chronic use of the proton pump inhibitor, omeprazole.

Unusual sequelae of adult-onset dermatomyositis.

A 44-year-old woman diagnosed with dermatomyositis 5 years ago based on progressive proximal muscle weakness, elevated creatine kinase, typical findings on electromyography and muscle biopsy. Despite the treatment, in contrast to improvement in her muscle symptoms, the heliotrope rash of her eyelids persisted. After several years, the patient developed multiple limited skin retraction lesions with hyperpigmentation on both lower limbs.

Adrenocortical carcinoma presenting as bilateral pitting leg oedema.

We report a case of a 54-year-old woman presented with bilateral pitting leg oedema. Initial workup for common aetiologies was unrevealing and diuretic therapy was ineffective. A CT scan of the abdomen demonstrated left adrenal mass with direct invasion of the adrenal vein and inferior vena cava with direct extension to the right atrium.