Topics
Endocrinology
When ‘Liver Enzymes’ Are Not Hepatic: Late-Onset Pompe Disease
Elevated liver function tests are commonly attributed to hepatic disease but may reflect extrahepatic pathology. We describe the case of an 18-year-old athletic woman with a 2-year history of elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatine kinase (CK) levels, initially investigated extensively for hepatic causes. Despite normal liver imaging and biopsy, ongoing abnormalities prompted metabolic evaluation, leading to the diagnosis of late-onset Pompe disease. This case highlights the diagnostic challenges of rare metabolic myopathies, the importance of recognising muscle-derived aminotransferase elevation and the need for broad diagnostic consideration when standard investigations are unrevealing.
Shauna Madigan, Georgina England, Wayne Rankin
Primary Hyperparathyroidism in Adults: Recent Developments in Diagnosis and Management
Primary hyperparathyroidism has a prevalence of around 1% in the general population. Diagnosis requires biochemical testing of serum (for calcium and parathyroid hormone) and urine (for calcium excretion), as well as wider screening for complications including osteoporosis, renal disease, abdominal symptoms and neuropsychiatric disturbance. In selected individuals, genetic testing is a key consideration because up to 10% have hereditary primary hyperparathyroidism. Surgery is curative, with a minimally invasive approach preferred after identifying the abnormal parathyroid glands on preoperative imaging. Uncertainty surrounds the diagnosis of non-classical manifestations of primary hyperparathyroidism, preoperative imaging algorithms and management pathways in normocalcaemic primary hyperparathyroidism.
Elizabeth Wootton, Sunita M. C. De Sousa, Richard L. Prince, Donald S. A. McLeod, David A. Pattison, Mathis Grossmann
Severe Hypoglycaemia Secondary to Chronic Opioid-Induced Hypothalamic–Pituitary–Adrenal Axis Suppression: An Under-Recognised Phenomenon
Michael Do, Annabelle Hayes, Malgorzata Brzozowska
Rethinking diabetes care for Indigenous Australians: the need for Indigenous‐codesigned and led diabetes models of care
The scale and complexity of diabetes in rural and remote Indigenous communities is an urgent health issue. Progress in improving diabetes care, closing entrenched gaps and, ultimately, improving the health of Indigenous people and communities nationwide can be achieved with concerted, multidisciplinary, culturally informed evidence-based efforts
Natalie Nanayakkara · Sharon Atkinson‐Briggs · Alicia J Jenkins · Neale D Cohen
The first Australian evidence‐based guidelines on male infertility
These first Australian evidence-based guidelines will serve as a clinical aid to practitioners who provide services to men with infertility and will facilitate evidence-based care for the most common areas of male infertility
Darren J Katz · Liza O’Donnell · Robert I McLachlan · Tim J Moss · Clare V Boothroyd · Veena Jayadev · Sarah R Catford
Cass Review does not guide care for trans young people
Good medicine is guided by the values of the patient, not those of a clinician, politician or commentator. The Cass Review, lacking expertise and compromised by implicit stigma and misinformation, does not give credible evidence-based guidance
Julia K Moore · Cate Rayner · S Rachel Skinner · Katie Wynne · Blake S Cavve · Brodie Fraser · Uma Ganti · Claire McAllister · Gideon Meyerowitz‐Katz · Tram Nguyen · Anja Ravine · Brian Ross · Darren B Russell · Liz A Saunders · Aris Siafarikas · Ken C Pang
Sex‐ and gender‐responsive management of anxiety disorders: future pathways for research, education, policy and practice
Better integration of sex and gender considerations in health and medical research, in Australian clinical practice guidelines, and in health and medical education curricula, is needed to improve the quality of care for all people with anxiety disorders
Bronwyn M Graham
Incidence of GLP‐1 receptor agonist use by women of reproductive age attending general practices in Australia, 2011–2022: a retrospective open cohort study
Further evidence and guidelines are needed for safe, effective use of GLP-1 receptor agonists by women of reproductive age
Kailash Thapaliya · Arianne Sweeting · Kirsten I Black · Amanda Poprzeczny · Danielle Mazza · Luke E Grzeskowiak
An Aboriginal women‐led approach to design a maternal and child health model when cardiometabolic complications are experienced in pregnancy in South Australia
Culturally responsive, person-centred care can bridge gaps between Aboriginal knowledge systems and biomedical paradigms, improving maternal, child and family health outcomes holistically
Karrina DeMasi (Barkandji) · Dana Shen (Ngarrindjeri) · Phoebe McColl · Amanda Richards‐Satour (Adnyamathanha and Barngarla) · Carolyn Renehan (Central Arrernte) · Kim Morey (Anmatyerr and Eastern Arrernte) · Karen Glover (Mein:tnk and Wotjobaluk) · Cathy Leane (Dharug) · Kristine Woods‐Hampton (Anmatijerre) · Lorraine Garay (Anangu) · Eloise Baker (Adnyamathanha and Barngarla) · Rebecca Nielsen (Kalkadoon) · Katharine Brown
Assessment of metabolic dysfunction‐associated fatty liver disease in primary care: a consensus statement summary
In recognition of the increasing burden of metabolic dysfunction-associated fatty liver disease (MAFLD) in Australia, and the lack of clear guidelines for general practitioners, this consensus statement summary presents 21 recommendations on the assessment and monitoring of MAFLD in adult patients in primary care
Leon A Adams · William W Kemp · Kate R Muller · Elizabeth E Powell · Stuart K Roberts · Luis Calzadilla Bertot · Stephanie Best · Gary Deed · Jon D Emery · Samantha L Hocking · Graham R Jones · John S Lubel · Sinead Sheils · Stephen M Twigg · Gerald F Watts · Jacob George
Australian and New Zealand joint society consensus statement on genetic testing for monogenic diabetes in adults
A molecular diagnosis of monogenic diabetes can guide family planning, cascade testing and surveillance for other manifestations
Sunita MC De Sousa · Timothy ME Davis · James Harraway · Mark Greenslade · Kathy HC Wu · Ryan G Paul · Juliet Taylor · Aleena S Ali · Elif I Ekinci · Rinki Murphy · Jerry R Greenfield
The incidence of and risk factors for hospitalisations and amputations for people with diabetes‐related foot ulcers in Queensland, 2011–19: an observational cohort study
Evidence-based profiling could identify people most likely to benefit from interventions for reducing the risk of hospitalisation
Yuqi Zhang · Susanna M Cramb · Steven M McPhail · Rosana Pacella · Jaap J Netten · Ewan M Kinnear · Peter A Lazzarini
Australasian Diabetes in Pregnancy Society (ADIPS) 2025 consensus recommendations for the screening, diagnosis and classification of gestational diabetes
Updated recommendations for the screening, diagnosis and classification of hyperglycaemia in pregnancy
Arianne Sweeting · Matthew JL Hare · Susan J Jersey · Alexis L Shub · Julia Zinga · Cecily Foged · Rosemary M Hall · Tang Wong · David Simmons
Severe hypoglycaemia secondary to chronic opioid‐induced hypothalamic–pituitary–adrenal axis suppression: an under‐recognised phenomenon
A 49-year-old woman with type 2 diabetes mellitus was hospitalised with critical hypoglycaemia
Michael Do · Annabelle G Hayes · Malgorzata M Brzozowska
Beware of the rinse: magic mouthwash as a rare cause of iatrogenic Cushing syndrome and secondary adrenal insufficiency
A 76-year-old female patient was urgently referred to the endocrine clinic for suppressed morning serum cortisol levels
Mike Lin · Lisa Horgan · Albert Hsieh
Interventions for Aboriginal and Torres Strait Islander people with type 2 diabetes that modify its management and cardiometabolic risk factors: a systematic review
Few interventions for Aboriginal and Torres Strait Islander people with type 2 diabetes have been reported in peer-reviewed publications
Ciying Tan · Zoe Williams · Mohammad Ashraful Islam · Ray Kelly · Tuguy Esgin · Elif I Ekinci
Management of people after stroke in 383 Victorian general practices, 2014–2018: analysis of linked stroke registry and general practice data
The general practice management of people who have been hospitalised with stroke or TIA could be improved
Muideen T Olaiya · Joosup Kim · Christopher Pearce · Kiran Bam · Dominique A Cadilhac · Nadine E Andrew · Lauren M Sanders · Amanda G Thrift · Mark R Nelson · Seana Gall · Monique F Kilkenny
Physical activity interventions to prevent and manage type 2 diabetes in Aboriginal and Torres Strait Islander people: a systematic review
Quality research into the impact of physical activity interventions on type 2 diabetes in Indigenous people is sparse
Raymond J Kelly · Rona Macniven · Leonid Churilov · Margaret J Morris · David O'Neal · Elif I Ekinci
Gender affirmation testosterone therapy, Australia, 2021–22: a review of PBS dispensing data
Knowing how many people use testosterone for gender affirmation is important for service provision and quality of care
Brendan J Nolan · Sav Zwickl · Jeffrey D Zajac · Ada S Cheung
Changes in the incidence of type 2 diabetes in Australia, 2005–2019, overall and by socio‐demographic characteristics: a population‐based study
The incidence of type 2 diabetes in Australian adults declined during 2010–2019 across all age, sex, socio-economic disadvantage, and remoteness groups
Dianna J Magliano · Lei Chen · Jedidiah I Morton · Oyunchimeg Buyadaa · Agus Salim · Jonathan E Shaw
Enhanced recovery after surgery: an update for the generalist
Barbara Depczynski · Brenda Ta · Sue Mei Lau
Glucocorticoid‐induced adrenal suppression: physiological basis and strategies for glucocorticoid weaning
Stephen Bacchi · Sheryn Tan · Mark Slee
Glucocorticoid‐induced adrenal suppression: physiological basis and strategies for glucocorticoid weaning
David J Torpy · Wu Tzen Lim