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Ana Gonçalves Ferreira, Tiago Nunes da Silva, Sofia Alegria, Maria Carlos Cordeiro, and Jorge Portugal

patient also reported worsening of his blood glucose levels and increasing constipation over the preceding weeks. At presentation, high blood pressure was noted (BP 185/89 mmHg) and the patient was found to be euvolemic. Cardiovascular and respiratory

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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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Ravikumar Ravindran, Justyna Witczak, Suhani Bahl, Lakdasa D K E Premawardhana, and Mohamed Adlan

presentation A 53-year-old retired fire-fighter, who was an obsessive body builder, presented with severe constipation of many weeks’ duration. He had no osmotic symptoms, bone or muscle pains, and denied other symptoms. He volunteered no erectile dysfunction

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Mohammed Al-Sofiani, Dhimitri Nikolla, and V V S Ramesh Metta

was associated with significant orthopnea causing insomnia the night before her ED presentation. She also noticed swelling of both lower limbs and hands. Review of systems was remarkable for lethargy, cold intolerance, constipation, menorrhagia for 5

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K Nadarasa, M Bailey, H Chahal, O Raja, R Bhat, C Gayle, A B Grossman, and M R Druce

, polydipsia, constipation and lethargy. On examination, a 3 cm mass was palpable in the right side of her neck. Biochemistry showed a corrected calcium level of 3.4 mmol/l (normal range, 2.15–2.65) and a PTH level of 53 pmol/l (normal range, 1.6–6.9). Both an

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

-orbital headaches, constipation, anorexia and nausea. Biochemical findings confirmed central hypocortisolism and hypothyroidism (refer Table 1 ). Magnetic resonance imaging (MRI) of the pituitary revealed a 9 mm TI hypointense contrast enhancing anterior pituitary

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Ricardo A Macau, Tiago Nunes da Silva, Joana Rego Silva, Ana Gonçalves Ferreira, and Pedro Bravo

room with diffuse abdominal pain and constipation for ten days. She had polydipsia (water intake estimated of 5 litre per day) and polyuria for years that had not been investigated. On admission, her clinical examination revealed abdominal distension

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Tessa Glyn, Beverley Harris, and Kate Allen

profound central hypothyroidism was made. Her additional symptoms included weight gain, ‘puffiness’ of the face, constipation and low mood. The remainder of her pituitary function was completed. This revealed a normal 9:00 h cortisol of 582 nmol/L (NR

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Mawson Wang, Catherine Cho, Callum Gray, Thora Y Chai, Ruhaida Daud, and Matthew Luttrell

presentation A 65-year-old female presented to the emergency department with a 2-week history of generalised lethargy, anorexia, vomiting, abdominal discomfort, constipation, myalgias and altered mental state. There were no constitutional symptoms of fevers

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Nikolaos Asonitis, Eva Kassi, Michalis Kokkinos, Ilias Giovanopoulos, Foteini Petychaki, and Helen Gogas

to the hospital with severe hypercalcemia (serum calcium level: 15.2 mg/dL). Her symptoms were muscle weakness, nausea, vomiting, constipation, polyuria and malaise. Upon physical examination, she was found to have a dry oral mucosa with loss of skin