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I R Wallace, E Healy, R S Cooke, P K Ellis, R Harper, and S J Hunter

. Case presentation A 43 year-old woman presented with a 3 month history of three stone weight loss, palpitations, anxiety, heat intolerance, sleep disturbance, tremor and increased energy. She had initially attributed her symptoms to stress, working in

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

recommendations and treated hypoglycaemia with fast-acting carbohydrates resulting in subsequent hypoglycaemia and disturbed sleep with excess daytime tiredness. FL was introduced at 22/40 in order to avoid frequent nocturnal finger prick BM measurements and as an

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Marlene Tarvainen, Satu Mäkelä, Jukka Mustonen, and Pia Jaatinen

started. The patient began to suffer from nausea, vomiting, and visual disturbances, and she was transferred to Tampere University Hospital. NE was suspected, and a point-of-care anti-PUUV antibody test (Reascan Puumala IgM, Reagena International, Toivala

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Ohoud Al Mohareb, Mussa H Al Malki, O Thomas Mueller, and Imad Brema

presenting complaint, he had no other symptoms of hyperthyroidism, such as excessive sweating, tremors, weight loss or disturbed sleep. He was unaware of any family history of thyroid dysfunction. He had good energy levels, normal libido and physical

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Alicja Szwilling, Katarzyna Dzygalo, and Jędrzej Nowaczyk

vision disturbances and tremors of the head and limbs exacerbated over time. Seizure-like episodes were reported. At the age of 10, brain MRI showed abnormalities characteristic of spongiform group of mitochondrial diseases. An abnormal EEG sleep study

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Laura Hamilton Adams and Derick Adams

cessation of menses at the age of 42 years. She had also noted occasional headaches but had not had any recent vision loss. She had no arthralgias and no symptoms of obstructive sleep apnea. Additionally, she had no heat intolerance, palpitations or weight

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M J Trott, G Farah, V J Stokes, L M Wang, and A B Grossman

described a multitude of symptoms including swelling of the face and peripheries, lethargy, muscle weakness, sleep disturbance and cognitive blunting, all of which caused significant detriment to her quality of life. She reported that since their onset in

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Noor Rafhati Adyani Abdullah, Wong Lok Chin Jason, and Azraai Bahari Nasruddin

finding appropriate shoes. He also complained of intermittent occipital headache, which was not associated with any visual disturbances. He had bilateral knee and ankle pain associated with bilateral knee swelling. The knee pain greatly limited his

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Roberto Salvatori, Adrian F Daly, Alfredo Quinones-Hinojosa, Albert Thiry, and Albert Beckers

age. When aged 17, he noticed some visual disturbances, which were ascribed to astigmatism and were treated with corrective lenses. A temporary improvement occurred but he reported that his vision again began to worsen. At the time, he also noted

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Eleanor P Thong, Sarah Catford, Julie Fletcher, Phillip Wong, Peter J Fuller, Helena Teede, and Frances Milat

hypoglycaemic seizure, which occurred in his sleep. Repeat spine imaging revealed a new fracture of the L1 vertebra. Given the recurrent fracture despite anti-resorptive therapy, consideration was given to teriparatide, an anabolic agent, for the treatment of