Carbimazole induced cholestatic hepatits

Thyrotoxicosis is a common disorder especially in women. Most of the patients tolerate antithyroid medications very well with very few developing life threatening side effects. A 64 years old gentleman was diagnosed with hyperthyroidism secondary to Grave's disease [autoimmune]. He was treated with Carbimazole 20 mg daily. With in a month, he presented with acute cholestatic hepatitis. The patient's symptoms and laboratory abnormalities resolved after withdrawing the offending drug and controlling his thyroid status first with beta blocker and subsequently with propylethioracil. Since the mechanism of liver damage is different, antithyroid medications can be interchanged without increasing the risk of further liver damage

case of hypokalaemia and dependent oedema induced by liquorice

Excessive intake of liquorice can cause hypokalaemia and hypertension and generally, the onset and severity of symptoms depend on the dose and duration of liquorice intake, as well as individual susceptibility. We describe a patient with hypokalaemia caused by long term consumption of liquorice. Thecase emphasizes the importance of considering a detailed patients' history, which often lead the treating physician to the correct clinical diagnosis

Calcification of basal ganglia in chronic hypoparathyroidism

Hypoparathyridism and pseudohypoparathyroidism are the common causes of pathological calcification in the brain. Though in 0.3- 1.5% cases it can be physiological, we describe a case of pathological basal ganglia calcification due to hypoparathyroidsm. A 39 years old diabetic lady who presented with neuropsychiatric problems and seizures and finally diagnosed as a primary hypoparathyroidism with symptoms related to metastatic calcification in the brain. This case emphasizes the importance of thinking about the whole spectrum of the disease even though the biochemical markers are stable on treatment