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Beverly T Rodrigues, Zulfiquer Otty, Kunwarjit Sangla and Vasant V Shenoy

developed increasing fatigue, weight gain of 6 kg and bloating, along with elevation in blood glucose levels to 8–13 mmol/l (144–234 mg/dl) following her third dose. Her blood tests revealed secondary hypothyroidism, normal prolactin levels and central

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Jaya Sujatha Gopal-Kothandapani, Veejay Bagga, Stephen B Wharton, Daniel J Connolly, Saurabh Sinha and Paul J Dimitri

histological presentation of XGH. Case presentation Patient 1 A 14-year-old female was initially referred with an 18-month history of lethargy, reduced appetite, abdominal pain, bloating and nausea. She developed a headache at a later stage that was

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Benjamin G Challis, Nicolai J Wewer Albrechtsen, Vishakha Bansiya, Keith Burling, Peter Barker, Bolette Hartmann, Fiona Gribble, Stephen O'Rahilly, Jens J Holst and Helen L Simpson

involving her limbs and face and a number of concurrent symptoms including constipation, early satiety, bloating, nausea and vomiting and weight loss. She reported symptoms consistent with hypoglycaemia and although paramedic assistance was sought on several

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Katia Regina Marchetti, Maria Adelaide Albergaria Pereira, Arnaldo Lichtenstein and Edison Ferreira Paiva

months prior to the described events with bloating, weakness, lack of appetite, nausea, weight loss, dyspnea and edema of the lower limbs. In the preceding 3 months, her general condition had worsened, and she experienced episodes of mental confusion and

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Peter Novodvorsky, Emma Walkinshaw, Waliur Rahman, Valerie Gordon, Karen Towse, Sarah Mitchell, Dinesh Selvarajah, Priya Madhuvrata and Alia Munir

passage of hyperosmolar content into the small bowel causing excessive release of GI hormones and shift of fluids into the GI lumen. It presents with abdominal pain, bloating, diarrhoea and vasomotor symptoms such as palpitations, flushing, sweating or

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Ayanthi A Wijewardene, Sarah J Glastras, Diana L Learoyd, Bruce G Robinson and Venessa H M Tsang

worse with bloating, he remained on 200 mg twice daily. Outcome and follow-up Case 1 Cushing’s manifestations improved on the combination of vandetanib and mitotane with urinary free cortisol remaining within normal limits (243 nmol/24 h