Endocrine Abstracts

A 42-year-old man undergoing ipilimumab therapy for stage IV metastatic melanoma presented after his third dose with vomiting, abdominal pain, hypotension, and pyrexia. He was treated as a presumed line sepsis. Four days prior to admission, thyroid function test showed T4 of 7.9 pmol/l and TSH 0.02 mU/l and he was treated with levothyroxine. A pituitary profile was carried out on admission and the results were as follows, cortisol was 24 nmol/l, testosterone <0....

Anna Spada is currently Full Professor at the School of Medice, University of Milan. Her main research interests are on signal transduction in pituitary cells, pathogenesis of pituitary tumors, genotype/phenotype relationships in acromegalic patients with gsp mutations, tissue specific GNAS1 gene imprinting, molecular mechanisms of resistance to hormone action, activating and inactivating mutations of GNAS1 in endocrine disorders, polymorphic variants of somatostatin receptor ...

SB, a 54-year-old male, was diagnosed with NF1 aged 11 on the basis of multiple café au lait spots and neurofibromas. In 1991 he presented with diarrhoea and weightloss and investigations revealed a duodenal mass and suspected hepatic metastases. Somatostatin levels were elevated, and histology confirmed a duodenal somatostatinma following Whipple’s procedure in 1991. The hepatic metastases were excised with good results. At follow up, SB remained symptom free treate...

Radioimmunoassays are used to measure hormones and the technique is based on recognition of an antigen by antibodies largely derived from animal sources. Heterophilic antibodies have been reported to cause interference in 0.05–0.5% of immunoassays. We present a case in which the presence of heterophilic antibodies led to unnecessary interventions.A 32 year old gentleman was referred to our centre to localise neuroendocrine tumour. He presented with ...

IntroductionThe typical pattern of thyroid function tests associated with secondary hypothyroidism, partial hypopituitarism and panhypopituitarism consists of subnormal free-T4, normal or marginally elevated TSH and normal T3 concentrations. Only laboratories offering frontline TFT’s including fT4 and TSH, rather than TSH alone, can identify such cases. Our prospective study assessed the number of cases of hypopituitarism which would be diagnosed by...

Medullary thyroid carcinoma (MTC) is hereditary in 25 per cent of cases. This may be in association with Multiple Endocrine Neoplasia (MEN) Type 2 (A and B) or as familial MTC (FMTC) alone. The mutations causing hereditary forms of MTC arise in the RET-proto-oncogene.A 40 yr old asymptomatic gentleman presenting with a mass in his neck. Fine needle aspiration of the mass revealed a probable medullary thyroid carcinoma. Total thyroidectomy and neck dissec...

Background: Prevalence of FHH in hypercalcaemic patients with a raised PTH has been quoted as 1 in 20. Parathyroidectomy has no benefit and therefore it is important to exclude FHH prior to considering surgery.Objectives: The aim of our study was to idenitify hypercalcaemic patients with a 24 hour urine calcium creatinine ratio (Ca/Cr) between 0.01–0.02 with a view to propose a cut-off ratio of 0.015 which will provide optimal...

Background: Prevalence of FHH in hypercalcaemic patients with a raised PTH has been quoted as 1 in 20. Parathyroidectomy has no benefit and therefore it is important to exclude FHH prior to considering surgery.Objectives: The aim of our study was to idenitify hypercalcaemic patients with a 24 hour urine calcium creatinine ratio (Ca/Cr) between 0.01–0.02 with a view to propose a cut-off ratio of 0.015 which will provide optimal...

Somatostatin analogues (SSA) have an established role in the medical management of patients with neuroendocrine tumours (NETs). They are effective in the symptomatic treatment of some metastatic NETs and may also provide tumour stabilisation or reduction. We report two patients with disease progression who benefited from SSA. Mrs HW, 64-year old woman, was diagnosed with a grade 1 small-bowel NET with lymph node and liver metastasis in 2012: Ki-67 index < 1%. Despite a seg...

Introduction: Current guidelines from The Endocrine Society indicate that 2 different tests from urinary free cortisol (UFC) measurement, salivary cortisol (SC) measurement, low-dose dexamethasone suppression test (LDDST) or overnight dexamethasone suppression test (ODST) are required to diagnose Cushing’s syndrome (CS). The low-dose dexamethasone test (LDDST) is often used as the confirmatory test when diagnosing CS. The overnight d...