Case Study: SIADH, Diabetes Mellitus, and Endocrine Disorder Analysis

This case study presents a comprehensive analysis of a 67-year-old woman's clinical presentation, focusing on the diagnosis and management of Syndrome of Inappropriate Antidiuretic Hormone (SIADH). The patient's history includes type 2 diabetes mellitus, peripheral neuropathy, COPD, and depression. Laboratory results reveal hyponatremia (low sodium levels), prompting referral to the emergency department and an endocrinology consult. The assignment requires defining SIADH and identifying potential causes and complications, including related endocrine disorders. The case study then explores various endocrine conditions, such as adrenal insufficiency, hyperparathyroidism, renal stones, hypothyroidism, and diabetes-related issues like polydipsia, polyuria, and ketoacidosis. It also delves into Cushing's disease, primary hyperaldosteronism, diabetes insipidus, thyroid storm, and pheochromocytoma, providing a broad overview of endocrine system disorders and their clinical manifestations. The analysis highlights the complex interplay of these conditions and their impact on patient health and treatment strategies. The case study includes references to support the analysis of each scenario and provides a thorough understanding of the various endocrine disorders.

Running head: CASE STUDY
CASE STUDY
Name of the Student
Name of the University
Author Note

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CASE STUDY
Answer Scenario 1.
SIADH or syndrome of Antidiuretic Hormone is a physiological state of the body
when the body produces more amount of antidiuretic hormone (ADH). It makes the body to
hold much water. The patient has a history of type 2 diabetes mellitus along with neuropathy.
Depression is also one common cause for this development (Yasir & Mechanic, 2019).
Answer Scenario 2.
The patient has developed this condition of adrenal insufficiency due to the prolong
period of rheumatoid arthritis which is an autoimmune disease damaging the cells. The
pituitary gland stops sensing the drug, which in turn lowers the secretion of corticotrophin.
The lack of ACTH results in vomiting, nausea and weight loss (Allen & Sharma, 2019).
Answer Scenario 3.
The hyperparathyroidism is caused by the over production of parathyroid hormone in
the body. The hormone raises the calcium concentration in the bones and absorption in the
small intestine resulting in high level of blood-calcium volume developing
hyperparathyroidism (Pokhrel & Levine, 2019).
Answer Scenario 4.
The renal stones are made of calcium that is caused due to hyperparathyroidism as
this hormone raises the calcium concentration in the body. The body of the patient consists of
salts along with calcium oxalate resulting in renal acidosis (Lila et al., 2012).
Hyperparathyroidism develops hypercalcemia along with development of
osteoporosis, which makes the bone weak and prone to break.
Answer Scenario 5.

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CASE STUDY
The problem of hypothyroidism can result in the development of cardiovascular
diseases, infertility problem, neurological issues and even death. The complication can be
caused due to the lower production of thyroid hormone in the body developing myxoedema
(Chaker et al., 2017).
Answer Scenario. 6.
1. Polydipsia is caused by increased level of blood glucose in the body along with a
feeling of thirsty. The body losses adequate amount of water by urination (Trimpou et
al., 2017).
2. Polyuria is a condition of body where more amount of urine is excreted from the
body. The kidneys filter more amount of water resulting in this condition (Trimpou et
al., 2017).
3. Diabetes results in using more amount of energy, burn fats due to loss of
carbohydrates from the body. To body tries to get energy from the rest part resulting
in weight loss.
4. Fatigue occurs due to lack of insulin or resistance of insulin, it damages the body’s
capacity to acquire more energy.
5. The environmental factor that cause type1 diabetes are entervirus infection that effects
the pancreas and the genetic factor that develop this condition are HLA-DQB1, HLA-
DRB1 and HLA-DQA1.
Answer Scenario 7.
Epinephrine origins a rapid increase in blood glucose absorption in the post absorptive
state. This result is facilitated by a brief increase in hepatic glucose construction and an
inhibition of glucose removal by insulin-dependent tissues resulting in ketoacidosis. The

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CASE STUDY
glucagon supresses the activity of the enzyme malonyl coenzyme resulting in ketoacidosis.
Higher level of corticol results in ketoacidosis by affecting the secretion of insulin hormone.
The growth hormone increases the breakdown of fatty acid resulting in high level of glucose
in the body developing ketoacidosis (Ghimire & Dhamoon, 2019).
Answer Scenario 8.
Diabetic hyperglycaemia hyperosmolar syndrome is triggered by very high blood
sugar level in the body without the presence of ketone. The kidney excretes more amount of
sugar resulting in dehydration (Mouri & Badireddy, 2019).
Answer Scenario 9.
Cushing disease is caused due to the tumour in the pituitary gland that results in over
production of ACTH along with cortisol. Cushing syndrome is a sign that is related to the
overproduction of cortisol in the body (Chaudhry & Singh, 2019).
Answer Scenario 10.
Primary hyperaldosteronism happens due to the additional secretion of the adrenal
gland. The condition occurs in patients due to idiopathic bilateral adrenal hyperplasia.
Answer Scenario 11.
The main two components of diabetes mellitus are improper secretion and more
amount of insulin resistance. It is also developed due to impaired glucose production and
damage of the beta cells of the pancreas (Goyal & Jialal, 2019).
Answer Scenario 12.

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Diabetes insipidus is caused due to the defective production of vasopressin hormone
resulting in large amount of urine production. The kidney fails to retain water (Kalra et al.,
2016).
Answer Scenario 13.
The production of thyroid hormone is generally governed by negative feedback
mechanism. The receptors gets activated which suppresses the production of the hormone and
thereby maintaining a narrow range.
Answer Scenario 14.
The thyroid storm develops due to the over production of thyroid hormone or
hyperthyroidism. The patient developed the condition due to an autoimmune disease named
Graves’ disease which affects the thyroid glands. The condition of thyroid storm can be
developed due to pneumonia that triggers the disease condition (Pokhrel & Bhusal, 2019).
Answer Scenario 15.
Hypothyroidism is a condition that can occur due to less production of thyroid
hormone. The cause can of autoimmune disease like hashimoto’s thyroiditis,
hyperthyroidism, radiation, psychiatric drugs, iodine deficiency in the body and defective
pituitary gland secretion (Peeters, 2017).
Answer Scenario 16.
Hypothyroidism results in myxedema. It is an accumulation of substances in the skin
such as glycosaminoglycans. It happens due to very low production of thyroid hormone in the
body (Peeters, 2017).
Answer Scenario 17.

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CASE STUDY
Pheochromocytoma is a condition where tumour develops in the adrenal gland. The
tumour develops in the chromatin cells of the adrenal gland. The symptoms of this disease
develops due to defective functions of adrenaline and noradrenaline. Symptoms are headache,
high blood pressure, panic attacks. The condition can be treated by alpha or beta drugs such
as phenoxybenzamine and atenolol (Lenders et al., 2014).

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References
Allen, M. J., & Sharma, S. (2019). Physiology, Adrenocorticotropic Hormone (ACTH).
In StatPearls [Internet]. StatPearls Publishing.
Chaker, L., Bianco, A. C., Jonklaas, J., & Peeters, R. P. (2017). Hypothyroidism. Lancet
(London, England), 390(10101), 1550–1562. https://doi.org/10.1016/S0140-
6736(17)30703-1
Chaudhry, H. S., & Singh, G. (2019). Cushing syndrome. In StatPearls [Internet]. StatPearls
Publishing.
Ghimire, P., & Dhamoon, A. S. (2019). Ketoacidosis. In StatPearls [Internet]. StatPearls
Publishing.
Goyal, R., & Jialal, I. (2019). Diabetes Mellitus Type 2.
Kalra, S., Zargar, A. H., Jain, S. M., Sethi, B., Chowdhury, S., Singh, A. K., ... & Malve, H.
(2016). Diabetes insipidus: The other diabetes. Indian journal of endocrinology and
metabolism, 20(1), 9.
Lenders, J. W., Duh, Q. Y., Eisenhofer, G., Gimenez-Roqueplo, A. P., Grebe, S. K., Murad,
M. H., ... & Young Jr, W. F. (2014). Pheochromocytoma and paraganglioma: an
endocrine society clinical practice guideline. The Journal of Clinical Endocrinology
& Metabolism, 99(6), 1915-1942.
Lila, A. R., Sarathi, V., Jagtap, V., Bandgar, T., Menon, P. S., & Shah, N. S. (2012). Renal
manifestations of primary hyperparathyroidism. Indian journal of endocrinology and
metabolism, 16(2), 258–262. https://doi.org/10.4103/2230-8210.93745

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Mouri, M., & Badireddy, M. (2019). Hyperglycemia. In StatPearls [Internet]. StatPearls
Publishing.
Peeters, R. P. (2017). Subclinical hypothyroidism. New England Journal of
Medicine, 376(26), 2556-2565.
Pokhrel, B., & Bhusal, K. (2019). Thyroid Storm.
Pokhrel, B., & Levine, S. N. (2019). Primary Hyperparathyroidism. In StatPearls [Internet].
StatPearls Publishing.
Trimpou, P., Olsson, D. S., Ehn, O., & Ragnarsson, O. (2017). Diagnostic value of the water
deprivation test in the polyuria-polydipsia syndrome. Hormones, 16(4), 414-422.
Yasir, M., & Mechanic, O. J. (2019). Syndrome of Inappropriate Antidiuretic Hormone
Secretion (SIADH). In StatPearls [Internet]. StatPearls Publishing.