Abstract Disclosure: B.R. Bedell: None. M. Fariduddin: J. Sanchez Perez: S.C. Kukreja: R.M. Sargis: Adrenocortical carcinoma is a rare malignancy, with approximately 2,000 cases reported in the United States since 1970.[1] Many secrete excess adrenocortical hormones, adding to morbidity and mortality. Surgery can be curative or prolong survival if diagnosis made early, but prognosis remains poor due delayed detection.[2] We present case of metastatic functional that presented consequences...

Post-thyroidectomy hypocalcemia is the most common complication after total thyroidectomy. Studies to examine role of low vitamin D in increasing post-thyroidectomy incidence have produced varying results. This study aimed assess whether deficiency increases risk hypocalcemia.This retrospective involved 244 patients who underwent thyroidectomy between 2014 and 2019. Patients were divided into two groups based on pre-operative levels. Group A B had (25-hydroxyvitamin D) levels ≥20 ng/ml <20...

Climate change is predicted to adversely impact human health in myriad ways, with increasing concerns regarding the of various climactic factors on chronic disease incidence, progression, complications, and management. To clarify current state knowledge, we conducted a scoping review identify knowledge gaps about climate diabetes. We comprehensive literature search across PubMed, EMBASE, Web Science databases, combining terms related "climate change" "diabetes" from January 1, 2018, through...

Abstract Disclosure: N. Sweis: None. J. Sanchez Perez: M. Fariduddin: R.M. Sargis: D.J. Toft: S. Reutrakul: Background: Pituitary apoplexy is a potentially fatal condition involving the infarction or hemorrhage of pituitary gland. Rarely, it can occur in setting an ACTH-secreting adenoma. Clinical Case: A 27-year-old female with past medical history obesity, spontaneous miscarriages, and amenorrhea presented to ER acute onset frontal headache throbbing quality, associated nausea vomiting....

Testicular cancer is seen commonly in young males and has a high cure rate if diagnosed treated early. It clinically presents with painless testicular swelling. We discuss the case of previously healthy male an aggressive which started swelling but primary site underwent necrosis secondary to its own vascular demand thus giving false impression resolution, not before metastasizing rest body. With this case, we aim highlight importance increasing awareness presenting symptoms need overcome...

Abstract A 48‐year‐old male patient with Type 2 diabetes mellitus(T2D), on insulin replacement therapy, glipizide, and dapagliflozin presented generalized weakness weight loss of 40 pounds in 6 months ever since he was started dapagliflozin. He hemodynamically stable arrival a finger stick glucose 121 gm%. Physical examination unremarkable except for dry mucus membranes. His laboratory results are shown Table 1. serum osmolar gap within the normal range. treated drip per DKA protocol closed,...

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Cholangiocarcinoma is one of the most lethal tumors because its complex location and lack good chemoradiotherapy options. When it diagnosed, urgent intervention needed, often involving radical surgical resection. It generally presents as a liver mass with biliary obstruction. We discuss case young patient presenting dysfunction imaging mimicking concerning for cholangiocarcinoma, where he actually had infarct from splanchnic venous thrombosis primary myelofibrosis.

Cushing's disease (CD) is the most common cause of endogenous cortisol excess. We discuss case a 60-year-old woman with recurrent venous thromboembolism, refractory hypokalemia, and lumbar vertebrae compression fractures rapidly progressive course. Ectopic hypercortisolism was suspected given patient's age rapid onset disease. Investigations revealed excess from pituitary microadenoma. This demonstrates that CD can present severe findings highlights increased risk thromboembolism in...

Introduction: Exertional Heat Stroke (EHS) is one of the leading causes death in young athletes. This commonly seen youngsters who engage heavy exercise during periods high ambient temperature. We report a case female developed bowel ischemia and shock liver after marathon run on warm summer afternoon. Case: A 27 y/o was brought to ER she collapsed an hour into marathon. At presentation hyperthermic with T 40.2 °C, encephalopathic hypotensive. She rapidly cooled IV cold normal saline cooling...

Introduction: Solifenacin is a drug commonly used for urge incontinence. We report case of an elderly female who presented with induced hepatitis. Case: An 84 y/o to the hospital abdominal pain, nausea and bilious vomiting 24 hours. At admission, her labs suggested acute hepatitis AST: 567, ALT: 939, Alkaline phosphatase: 171, rest work up including bilirubin, total protein, platelet count PT, PTT INR being within normal limits. A right upper quadrant ultrasound abdomen showed small amount...

Abstract Disclosure: M. Fariduddin: None. J. Sanchez Perez: U.N. Syed: Y. Eisenberg: R.M. Sargis: Introduction: Ectopic ACTH-dependent Cushing’s syndrome (CS) is a rare entity accounting for 10-20% of hypercortisolism cases. We present patient with this syndrome. Case Presentation: A 72-year-old man diagnosed metastatic prostate cancer to the lumbar spine and pelvis was admitted persistent hypokalemia. Potassium levels were 2.1 mmol/L (ref. range: 3.5-5.2) despite aggressive potassium...

Abstract Disclosure: J. Sanchez Perez: None. M. Obeid: Fariduddin: D.J. Toft: Introduction: Thyroglobulin (TG) measurement is a major means of detecting recurrence previously treated differentiated thyroid cancers. Human-Anti Mouse Antibodies (HAMA) can interfere with lab measurements TG levels and affect clinical decisions treatment for these cancers.Clinical Case: A 65-year-old female was diagnosed papillary cancer (PTC). Surgical pathology following total thyroidectomy demonstrated tumor...

Abstract Disclosure: M. Fariduddin: None. A. Lupieri: H.L. Calero: Rubenfeld: Y. Eisenberg: Case: 22 y/o pregnant female (5 weeks gestation) presented to the endocrinology clinic after a hospital admission for nausea, vomiting, constipation, fatigue and joint pain with labs showing calcium (corrected) of 14 mg/dL PTH 1200 pg/ml. Labs in showed at 16 1500 She was re-admitted IV fluids, calcitonin zoledronic acid. Severe hypercalcemia, young age, extremely high levels were highly suggestive...

Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome of unchecked immune activation leading to multi-organ damage with high mortality. It can be hereditary or triggered by an inflammatory process. Mild hepatitis present in the majority patients HLH, but obstructive jaundice has not been reported. We case 60 year old male who presented severe from HLH underlying lymphoma. A y/o history DM, CAD and CKD jaundice, fevers fatigue. His bilirubin was 22 20.1 direct; ALT 33, AST 87, Alk phos...

Familial adenomatous polyposis (FAP) is an inherited disease that characterised by multiple recurrent cancers of the colon (large intestine). Thyroid nodules and thyroid cancer are among few extraintestinal manifestations FAP, with a prevalence 35-80% 3-12% respectively. The incidence higher in FAP patients than general population. However, routine screening not consistently performed most practitioners when managing FAP. We sought to assess frequency these patients. retrospective chart...