The emergence of a novel coronavirus and global pandemic raised the need for the rapid development of new vaccines to reduce the morbidity and mortality associated with Covid-19. Common side effects of these vaccines such as myalgia, arthralgia, nausea, fatigue, and injection site reaction are usually self-resolving. Recognition of other potential adverse effects of these novel vaccines is important due to their rapid and widespread distribution. We report a case of a 51-year-old man admitted to Parkland Memorial Hospital with headache, nausea, vomiting, malaise, and diffuse arthralgias 3 days after he received his second mRNA-1273 SARS-CoV-2 vaccination. He was found to have hyponatremia and a low serum cortisol level. Further workup revealed hypopituitarism with central hypothyroidism, hypogonadism, and a subnormal response to cosyntropin. Magnetic resonance imaging revealed a diffusely enlarged pituitary gland consistent with acute hypophysitis. The patient responded well to glucocorticoid and thyroid hormone supplementation and was discharged after 2 days in the hospital. This is the first reported case of hypopituitarism potentially associated with Covid-19 immunization.
Objective The aim of this study was to examine the relationships between body weight changes, health behaviors, and mental health in adults with obesity during the second year of the COVID‐19 pandemic. Methods Between March 1, 2021, and November 30, 2021, adults from three obesity practices completed an online survey. The primary outcomes were ≥ 5% of body weight change since March 2020 and associated health behaviors and mental health factors. Results The sample (n = 404) was 82.6% female (mean age 52.5 years, mean BMI 43.3 kg/m2). Mean weight change was + 4.3%. Weight gain ≥ 5% was reported by 30% of the sample, whereas 19% reported ≥ 5% body weight loss. The degree of both weight gain and weight loss correlated positively with baseline BMI. Eighty percent of the sample reported difficulties with body weight regulation. Those who gained ≥ 5% versus those who lost ≥ 5% body weight were more likely to report higher levels of stress, anxiety, and depression; less sleep and exercise; less healthy eating and home‐cooked meals; and more takeout foods, comfort foods, fast foods, overeating, and binge eating. Conclusions Weight gain in adults with obesity during the COVID‐19 pandemic is associated with higher baseline BMI, deteriorations in mental health, maladaptive eating behaviors, and less physical activity and sleep. Further research is needed to identify effective interventions for healthier minds, behaviors, and body weight as the pandemic continues.
Patient: Male, 27Final Diagnosis: Hypertriglyceridemia associated acute pancreatitis secondary to diabetic ketoacidosisSymptoms: Abdominal painMedication: —Clinical Procedure: —Specialty: Endocrinology and MetabolismObjective:Rare diseaseBackground:Severe hypertriglyceridemia is a well-known cause of acute pancreatitis. Mild elevations of triglyceride levels are common in patients presenting with diabetic ketoacidosis (DKA). Rarely, DKA can be accompanied by an elevation of serum triglyceride level severe enough to lead to AP.Case Report:We report one such case of a young diabetic male who presented with DKA that was complicated by hypertriglyceridemia-induced acute pancreatitis (HTGAP). We were able to treat the condition with a slightly prolonged infusion of intravenous (IV) regular insulin in an efficient and cost-effective manner with a good outcome.Conclusions:From our experience, DKA-associated HTGAP can be rapidly, efficiently, and cost-effectively treated with IV regular insulin and close biochemical monitoring. A high index of suspicion for acute pancreatitis is necessary in patients with DKA, especially with co-existing hypertriglyceridemia; and all efforts should be made to diagnose it in a timely manner to prevent subsequent complications.
Objective The aim of this study was to compare the effectiveness of semaglutide versus liraglutide for treating post‐metabolic and bariatric surgery (MBS) weight recurrence. Methods A retrospective analysis of 207 adults with post‐MBS weight recurrence treated with semaglutide 1.0 mg weekly (n = 115) or liraglutide 3.0 mg daily (n = 92) at an academic center from January 1, 2015, through April 1, 2021, was conducted. The primary end point was percentage body weight change at 12 months of treatment with regimens containing semaglutide or liraglutide. Results The mean sample age was 55.2 years; mean BMI was 40.4 kg/m2; 89.9% were female; and 50% completed sleeve gastrectomy, 29% completed Roux‐en‐Y gastric bypass, and 21% completed adjustable gastric banding. Least‐squares mean weight change at 12 months was −12.92% versus −8.77% in the semaglutide and liraglutide groups, respectively (p < 0.001). The adjusted odds ratios were 2.34 (95% CI: 1.28‐4.29) for ≥10% weight loss and 2.55 (95% CI: 1.22‐5.36) for ≥15% weight loss over 12 months in the semaglutide group versus liraglutide group, respectively. Weight‐loss efficacy of semaglutide (vs. liraglutide) did not differ by subgroups explored, including age, sex, and MBS procedure. Conclusions These results show that treatment regimens including semaglutide 1.0 mg weekly lead to superior weight loss compared with liraglutide 3.0 mg daily for treating post‐MBS weight recurrence, regardless of procedure type or the magnitude of weight recurrence.
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