MyMedR

Displaying all 6 publications

Abstract:

Sort:

Fulltext Ectopic adrenocorticotrophic hormone syndrome (EAS) with phaeochromocytoma: a challenging endocrine case with a happy ending

Wan Muhamad Hatta SF, Lekkakou L, Viswananth A, Buch H

BMJ Case Rep, 2019 Aug 20;12(8).
PMID: 31434676 DOI: 10.1136/bcr-2019-230636

Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is rarely caused by a phaeochromocytoma. We report a case of a 51-year-old woman with an 8-year history of severe constipation who underwent extensive investigations including gastroscopy, colonoscopy, ultrasonography, colonic transit studies and isotope defeacography, which did not reveal any pathology other than slow colonic transit time. The unifying diagnosis of ectopic ACTH and phaeochromocytoma was made after the case was initially investigated for an adrenal incidentaloma. Multiple challenges had to be overcome prior to surgery for the functioning adrenal adenoma including management of refractory hypokalaemia, poor nutritional status, persistent hyperglycaemia, labile blood pressure and florid hypercortisolaemia driving the metabolic derangements. She underwent an uneventful left-sided adrenalectomy and required no medication thereafter with normal blood pressure, blood glucose and serum potassium and resolution of constipation and abdominal symptoms. In conclusion, patients with EAS related to phaeochromocytoma are rare and present with distinctive diagnostic and management challenges but if diagnosed successfully and managed intensively, they are curable.
Fulltext Recurrent primary hyperparathyroidism: a diagnostic and management dilemma

Wilkinson B, Wan Muhamad Hatta SF, Garnham A, Buch HN

Endocrinol Diabetes Metab Case Rep, 2021 Apr 01;2021.
PMID: 33913436 DOI: 10.1530/EDM-20-0136

SUMMARY: Primary hyperparathyroidism requires a surgical approach to achieve a long-term cure. However, post-surgical recurrence significantly complicates the management of this condition. A number of causes for recurrent disease are well understood and several diagnostic modalities exist to localise the culprit parathyroid adenoma although none of them is efficacious in localisation of the recurrent lesion. In this case report, we highlight a novel causative mechanism and describe a unique diagnostic sequence that enabled curative treatment to be delivered.
LEARNING POINTS: In the case described herein, we describe a novel location for a parathyroid adenoma causing recurrent PHPT. The case elucidates well the difficulties presented by such cases in terms of surgical planning and show the utility of PVS in such cases. Based on this case, we make the following recommendations: Meticulous care must be taken to prevent seeding of adenomatous tissue during primary excision. To consider the use of PVS in patients with discordant imaging in the setting of recurrent/persistent PHPT as a method to localise the causative adenoma. Same day PVS and surgery is a viable option for patients who either represent an anaesthetic risk or who are extremely anxious about the prospect of two separate procedures. Disordered calcium homeostasis is an important but forgotten cause of dysphagia which can be extremely debilitating for affected patients.
Fulltext Denosumab as the Treatment of Recalcitrant Tuberculous Pleural Effusion-Associated Hypercalcemia

Abd Jalil AA, Wan Muhamad Hatta SF, Mohamad AF, Abdul Rani MF

Case Rep Med, 2021;2021:5544848.
PMID: 33986809 DOI: 10.1155/2021/5544848

Denosumab is a human monoclonal antibody that binds to RANKL (receptor activator of nuclear factor-kappa B ligand). It has mainly been used in the treatment of osteoporosis for a variety of causes especially in situations refractory to bisphosphonates or when kidney function is impaired. It is also used in cases of malignancy-associated hypercalcemia. There are many causes of hypercalcemia, but only rarely it is associated with granulomatous diseases such as tuberculous pleural effusion. We report a case of hypercalcemia from tuberculous pleural effusion that was initially admitted with left medium abundance pleural effusion and a serum corrected calcium level of 3.48 mmol/L. The calcium level was successfully normalized within 72 hours of subcutaneous denosumab administration after other interventions have failed.
Fulltext Granulomatous hypophysitis: a case of severe headache

Wan Muhamad Hatta SF, Hamdan MF, Md Ali SA, Abdul Ghani R

BMJ Case Rep, 2016 Sep 09;2016.
PMID: 27613264 DOI: 10.1136/bcr-2016-216395

Idiopathic granulomatous hypophysitis (GH) is an uncommon inflammatory disease of the pituitary with impairment of pituitary gland function due to infiltration by lymphocytes, plasma cells and macrophages. We report the case of a 39-year-old woman who presented with worsening of headaches for 1 month and blurring of vision over 5 days. An MRI revealed a homogeneous supra-sellar mass evoking a pituitary tumour with bulky pituitary stalk extending into the left and right cavernous sinuses. Hormonal investigations showed anterior pituitary hormone deficiencies; meanwhile histopathological examination revealed an aspect of hypophysitis. Clinical and radiological remission occurred immediately postglucocorticoid therapy with the addition of a steroid-sparing agent later in view of recurrence of symptoms on glucocorticoid dose reduction. GH has important diagnostic and therapeutic implications, as clinical and radiological features ameliorate via medical treatment. With further understanding and recognition of the disease, we hope to highlight a case of GH, in which signs and symptoms improved after initiation of corticosteroids.
Fulltext A case report on a protracted course of a hidden insulinoma

Mohamed Shah FZ, Mohamad AF, Zainordin NA, Eddy Warman NA, Wan Muhamad Hatta SF, Abdul Ghani R

Ann Med Surg (Lond), 2021 Apr;64:102240.
PMID: 33868680 DOI: 10.1016/j.amsu.2021.102240

Introduction: Insulinoma is a functioning pancreatic neuroendocrine tumor primarily leading due to hypoglycemia due to hypersecretion of insulin. This case illustrates the real challenges faced in the detection of an occult insulinoma, which resulted in a protracted course of the disease.
Case presentation: A 33-year-old female presented with recurrent hypoglycemia. Endogenous hyperinsulinemia was confirmed by a prolonged fast, however serial imaging was negative. Incidental finding of an ovarian mass gave rise to the suspicion of an insulin-producing ovarian tumor. Subsequent multimodality pancreatic imaging remained negative, requiring more invasive investigations. The tumor was localized by specialized arteriography using calcium stimulation to support the diagnosis of an insulinoma. However, repeated negative imaging led to further delays in definitive management, with worsening hypoglycemia. The surgery was finally performed three years after the initial presentation with successful removal of the tumor using intra-operative ultrasound.
Clinical discussion: It is important to emphasize that preoperative radiological imaging is useful to localize pancreatic lesions. However, most insulinomas could only be detected intraoperatively. The absence of suggestive radiological evidence should not deter surgeons from proceeding with definitive surgical intervention.
Conclusion: The case highlights the importance of a multidisciplinary approach in the management of a complicated case.
Fulltext Degradation of Perovskite Thin Films and Solar Cells with Candle Soot C/Ag Electrode Exposed in a Control Ambient

Islam MA, Mohafez H, Sobayel K, Wan Muhamad Hatta SF, Hasan AKM, Khandaker MU, et al.

Nanomaterials (Basel), 2021 Dec 20;11(12).
PMID: 34947812 DOI: 10.3390/nano11123463

Perovskite solar cells (PSCs) have already achieved efficiencies of over 25%; however, their instability and degradation in the operational environment have prevented them from becoming commercially viable. Understanding the degradation mechanism, as well as improving the fabrication technique for achieving high-quality perovskite films, is crucial to overcoming these shortcomings. In this study, we investigated details in the changes of physical properties associated with the degradation and/or decomposition of perovskite films and solar cells using XRD, FESEM, EDX, UV-Vis, Hall-effect, and current-voltage (I-V) measurement techniques. The dissociation, as well as the intensity of perovskite peaks, have been observed as an impact of film degradation by humidity. The decomposition rate of perovskite film has been estimated from the structural and optical changes. The performance degradation of novel planner structure PSCs has been investigated in detail. The PSCs were fabricated in-room ambient using candle soot carbon and screen-printed Ag electrode. It was found that until the perovskite film decomposed by 30%, the film properties and cell efficiency remained stable.