Endocrine Case Studies

Case 1: Diabetes Mellitus (Type 1)

  • Patient: Mr. Ananda, 45, exhausted, weight loss, unconscious.
  • Symptoms: Severe fatigue, unexplained weight loss, polydipsia, polyuria, "fruity" breath.
  • Lab Results: High plasma glucose, low serum bicarbonate, very low C-peptide.
  • Cause: Lack of insulin from pancreatic β-cells.
  • Diagnosis: Type 1 Diabetes Mellitus with DKA.

Case 2: Acromegaly

  • Patient: Mrs. Gita, 50, enlarging hands/feet, prominent jaw, headaches.
  • Symptoms: Enlarging hands and feet, coarsening facial features, headaches.
  • Lab Results: High IGF-1, GH not suppressed by glucose.
  • Cause: Excess Growth Hormone (GH) from a pituitary tumor.
  • Diagnosis: Acromegaly.

Case 3: Hypothyroidism (Hashimoto's)

  • Patient: Mrs. Devi, 40, fatigue, weight gain, cold intolerance.
  • Symptoms: Fatigue, weight gain, cold intolerance, dry skin, constipation.
  • Lab Results: High TSH, low Free T4, positive Anti-TPO Antibodies.
  • Cause: Low thyroid hormone (T4) due to autoimmune destruction of thyroid gland.
  • Diagnosis: Primary Hypothyroidism (Hashimoto's Disease).

Case 4: Hyperthyroidism (Graves' Disease)

  • Patient: Mr. Raj, 35, hand tremor, weight loss, heat intolerance, rapid heartbeat.
  • Symptoms: Hand tremors, weight loss, heat intolerance, rapid heartbeat, bulging eyes.
  • Lab Results: Low TSH, high Free T4, positive Thyroid Stimulating Immunoglobulin (TSI).
  • Cause: Autoantibodies mimicking TSH, leading to excess thyroid hormone.
  • Diagnosis: Hyperthyroidism (Graves' Disease).

Case 5: Cushing's Syndrome

  • Patient: Ms. Priya, 55, central obesity, thin limbs, "moon face."
  • Symptoms: Central obesity, thin limbs, "moon face," "buffalo hump," high blood pressure, easy bruising.
  • Lab Results: High 24-hr urine cortisol, low plasma ACTH.
  • Cause: Excess cortisol from an adrenal tumor.
  • Diagnosis: Cushing's Syndrome.

Case 6: Addison's Disease

  • Patient: Mr. Singh, politician, severe weakness, low blood pressure, hyperpigmentation.
  • Symptoms: Severe fatigue, low blood pressure, salt cravings, hyperpigmentation.
  • Lab Results: Low morning cortisol, high plasma ACTH, low serum sodium, high serum potassium.
  • Cause: Adrenal gland failure (lack of cortisol and aldosterone).
  • Diagnosis: Primary Adrenal Insufficiency (Addison's Disease).

Case 7: Hyperparathyroidism

  • Patient: Mrs. Lakshmi, 65, easy bone fractures, achy, constipated.
  • Symptoms: Bone pain/fractures, kidney stones, abdominal pain, depression.
  • Lab Results: High serum calcium, high PTH (despite high calcium).
  • Cause: Excess Parathyroid Hormone (PTH) from a parathyroid tumor.
  • Diagnosis: Primary Hyperparathyroidism.

Case 8: Kallmann Syndrome

  • Patient: Leo, 19, absent puberty, inability to smell.
  • Symptoms: Absent puberty, anosmia (inability to smell).
  • Lab Results: Very low testosterone, very low LH/FSH.
  • Cause: Failure of GnRH neurons to migrate to the hypothalamus during fetal development.
  • Diagnosis: Kallmann Syndrome.

Hypothalamic Hormones

  • TRH (Thyrotropin-Releasing Hormone): Stimulates TSH release.
  • CRH (Corticotropin-Releasing Hormone): Stimulates ACTH release.
  • GnRH (Gonadotropin-Releasing Hormone): Stimulates LH and FSH release.
  • GHRH (Growth Hormone-Releasing Hormone): Stimulates GH release.
  • Somatostatin (GHIH): Inhibits GH release.
  • Dopamine (PIH): Inhibits Prolactin release.