Diagnosis

• plasma growth hormone excess

• elevated insulin-like growth factor 1

• CT scanning pituitary

Hypopituitarism

This rare disorder should be considered with:

• a history of postpartum haemorrhage

• symptoms of hypothyroidism

• symptoms of adrenal insufficiency

• symptoms suggestive of a pituitary tumour

Primary hyperparathyroidism

Hyperparathyroidism is caused by an excessive secretion of parathyroid hormone and is usually due to a parathyroid adenoma. The classic clinical features of hyperparathyroidism are due to the effects of hypercalcaemia. Rarely, a parathyroid crisis in a misdiagnosed patient may result in death from severe hypercalcaemia.

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