Research Clinical Endocrinology & Metabolism

Week 7: Initial Response Discussion: Urinary Frequency Case Study 3 A 52-year-old woman presented to the clinic for ongoing fatigue and weight loss during the last 6 weeks. She thinks she’s loss at least “10 pounds”. For the past week and a half, she’s noted some progressing ‘muscle cramping’ tetany, as well as ‘tingling’ sensation around her mouth and lower extremities. She’s also noted some intermittent colicky abdominal pain. On your exam, you noted a positive Chvostek’s sign. PMH: 20-year history of Crohn’s disease. She also tells you that she is a practicing vegan. Primary Diagnosis The primary diagnosis of this case study based on the symptoms Hypocalcemia. Low calcium levels in the body can be detrimental to the quality of Life. Hypocalcemia is a result of either increased calcium loss from the circulation (deposition in tissue, increased urinary excretion, increased binding within the circulation) or decreased entry of calcium into the circulation (malabsorption, decreased bone resorption) (Buttaro, Trybulski, Polgar Bailey, & Sandberg-Cook, 2017). This patient presents with clinical symptoms that would present as hypocalcemia. Patients may display symptoms such as neuromuscular irritability, tetany, and seizures (Buttaro et al., 2017). A positive Chvostek’s sign typically is a good clinical indication leading to this diagnosis. Differential Diagnosis The first differential diagnosis I would use is vitamin D deficiency. Vitamin D is essential for the body to ensure healthy bone growth as well as preventive measure against some cancers. Vitamin D is also commonly to protect adults from osteomalacia as well protection from diabetes mellitus, cancer, multiple sclerosis and hypertension (Khushdil, Ullah, Ali, Khan, & Awan, 2016). Vitamin D symptoms usually are fatigue, muscle camps and muscle weakness (Buttaro et al., 2017). Due to this patient’s history of being a vegan, it is possible her dietary needs aren’t being met substantially. Lacking vitamin D can lead to hypocalcemia, as vitamin D is responsible for increasing the gut absorption of dietary calcium (Bove-Fenderson, & Mannstadt, 2018). Hypoparathyroidism is another diagnosis potentially for this patient. This is characterized by impaired secretion of parathyroid hormone (PTH) which is a key regulatory hormone for maintaining calcium (Bove-Fenderson, & Mannstadt, 2018). When there is an off balance in this area, the calcium levels become uncontrolled, which could be a reason as to why the patient has presented as such. Malabsorption Syndromes would be the last differential diagnosis. Malabsorption syndromes refer to the number of disorders in which the small intestine can’t absorb enough of certain nutrients and fluids. Being that this patient has crohn’s disease that would affect how the lack of calcium. Patient History and Physical Patient history and physical is a key competent in confirming a diagnosis. This patient is a vegan with a history of Crohn’s disease. Crohn’s disease can ultimately lead to electrolyte imbalances due to the nature of the disease. This can also be issues with malabsorption. As the practitioner we will need to assess her medications, what might her diet be like and is she receiving enough nutrients even still being a vegan. Another area of concern would be any recent acute illness. Any recent episodes of vomiting or diarrhea can be associated with the loss of electrolytes (Buttaro et al., 2017). Potential Treatment Treatment and management options for chronic hypocalcemia vary depending on the underlying disorder. The treatment for hypocalcemia typically is to replace the calcium and correct any underlying disorders. Depending on lab results, treatment can be as simple as extra milk within the diet, or the need of IV calcium gluconate (Buttaro et al., 2017). It is rather vital for a practitioner to know the how to detect and diagnosis electrolyte imbalances as they can be crucial to a patient’s life if missed. Furthermore, we want to check labs such as CMP, BUN, BMP, renal function as well as electrolytes. If thyroid disorder is suspected, a thyroid function test should be performed as well. An EKG can be completed to ensure there are no changes with the rhythm or rate of the heart. References Bove-Fenderson, E., & Mannstadt, M. (2018). Hypocalcemic disorders. Best Practice & Research Clinical Endocrinology & Metabolism, 32(5), 639–656. https://doi-org.ezp.waldenulibrary.org/10.1016/j.beem.2018.05.006 Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2017). Primary care: A collaborative practice (5th ed.). St. Louis, MO: Elsevier. Khushdil, A., Ullah, S., Ali, S., Khan, I., & Awan, T. (2016). Hypovitaminosis D in Healthy Students of a Medical College. Khyber Medical University Journal, 8(4), 162–164. Retrieved from https://search-ebscohost-

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Clinical endocrinology is the study of the endocrine system, its function and its diseases or abnormalities. The endocrine system refers to those organs in the body which release hormones that regulate many of the body’s functions such as the pancreas, the pituitary gland and the thyroid gland. Clinical endocrinology may treat any types of disorders of metabolism and bridge the negative consequences on things like bone strength and stability due to loss of hormones as a normal effect of aging.

Annals of Clinical Endocrinology and Metabolism publishes studiously peer-reviewed manuscripts integrating latest empirical and exploratory researches, reviews and analytical opinions penetrating into valuable and key aspects and issues related to clinical endocrinology and metabolism.

Apart from publishing innovatory manuscripts Annals of Clinical Endocrinology and Metabolism strives to promote a platform for the authors’, researches and doctors to promote and discuss various upcoming issues in various disciplines related to endocrinology and metabolism.

Reasons for Publishing
Endocrinology and metabolism underlie every aspect of our lives, from the functioning of a single cell through enhancing human strength and ability such as running a marathon. Therefore it is needless to say that defects in endocrine or metabolic function underlie so many common human diseases, including cancer, cardiovascular disease and neurodegenerative disorders.

Hence, perceiving the significance of in-depth studies in clinical endocrinology and metabolism, Annals of Clinical Endocrinology and Metabolism initiated publishing manuscripts incorporating distinguished research and pioneering studies to enhance the present knowledge in the arena of endocrinology and metabolism.Research Clinical Endocrinology & Metabolism.

Aim of the Journal
The manuscripts published in Annals of Clinical Endocrinology and Metabolism aims to augment the understanding in basic physiological mechanisms as well as creating new therapeutic approaches towards endocrine and metabolic research.

Annals of Clinical Endocrinology and Metabolism seeks to establish clinical endocrinology and metabolic research as profound importance to society through publishing and disseminating contemporary advancements in these fields.

Scope of the Journal
The scope of Annals of Clinical Endocrinology and Metabolism traverses vibrant and comprehensive researches ranging from the highly molecular to physiological studies in clinical endocrinology and metabolism. Annals of Clinical Endocrinology and Metabolism urges the authors, doctors and researchers to develop manuscripts and send to us for publication in the following, but not limited to disciplines of clinical endocrinology and metabolism: Research Clinical Endocrinology & Metabolism.