Endocrine Abstracts

Background: It is still undetermined whether patients with Cushing’s disease (CD) in remission have an increased mortality. Most previous studies are limited by small numbers of patients and/or short follow-up time.Objective: To study mortality in a nation-wide cohort of patients with CD during long-term follow-up.Methods: Patients with ICD codes for Cushing’s syndrome and/or CD, between 1987 and 2013, were identified in ...

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) occurs in 10-45% of patients and secretion of ectopic adrenocorticotrophic hormone (EAS) in 2.5% of patients with small cell lung cancer (SCLC). Simultaneous secretion of ADH and ACTH is rare with only 10 cases being reported. The varying biochemical data leads to misdiagnosis as this case demonstrates. A 67 year old male presented with a 2 week history of falls attributed to alcohol abuse. Physical signs ...

A 48-year-old female received radioiodine ablation therapy for thyrotoxicosis secondary to a solitary toxic nodule. The subsequent unexpected requirement for replacement thyroxine was explained by Hashimoto’s thyroiditis with an anti-thyroid peroxidase antibody level of 692.3 IU/ml. Thirty months later she presented with debilitating left facial pain and painful sensory symptoms of her left arm and leg. She was euthyroid taking thyroxine 75 μg daily with a fT4</...

The AhR is a ligand dependent transcription factor which belongs to the bHLH-PAS family of transcription factors. Together with it partner factor ARNT the AhR mediates the biological of numerous ligands includings dietary factors, tryptophane derivatives and environmental pollutants like polyaromatic hydrocarbons and poly-chlorinated dioxins.Exposure to these environmental pollutants leads to, among other effects, disruption of hormonal signaling pathway...

Background: Patient Safety Noticed issued by Welsh Government in June 2021 set out multiple action plans to be implemented by Welsh health boards to improve recognition and management of adrenal crisis. Hospitals were advised to review policies to ensure all patients at risk of Adrenal Crisis [(primary/secondary/tertiary adrenal insufficiency (AI)] were identified.Aim: In response, our hospital commenced a quality improv...

The non-specific symptoms of Addison’s disease may be attributed to other conditions with consequent delay in diagnosis. We describe such a case of novel presentation. A 61 year old female presented with a one-day history of vomiting, abdominal pain and 15kg weight loss over 6 months. PMH: hypertension of 15 years duration, chronic kidney disease (CKD3) for 7 years and hysterectomy for endometrial carcinoma 8 years earlier. Examination: dehydrated, sinus tachycardia 110 b...

Spontaneous resolution of primary hyperparathyroidism following infarction for parathyroid adenomas is rare with infarction on treatment with cinacalcet being even rarer. A 53 year old female who presented to primary care with malaise was found to have biochemical evidence of primary hyperparathyroidism with adjusted calcium 3.31 mmol/l and parathyroid hormone 28.8 pmol/l. Previous medical history was unremarkable. Following discussion with endocrinology, treatment with cinaca...

Context: The nadir serum GH level during glucose suppression (OGTT) is recommended in patients treated by surgery, but not during SA treatment. We have shown that patients considered controlled by SA don’t suppress serum GH during OGTT and have impaired disease-specific QoL as compared to patients controlled by surgery. We hypothesize SA treated patients also don’t suppress GH in response to mixed meals.Aim: To compare GH levels during two mixe...

Introduction: Worldwide constantly rising incidence of thyroid cancer promotes research activities. Nowadays the most speculated issue is the clinical significance of BRAF mutation. For sure BRAF mutation is a cancer-specific somatic mutation consistent with papillary thyroid cancer phenotype, otherwise, its role in tumor aggressiveness, progression, and the overall poor outcome is controversial. As far as several clinical studies claim opposing opinions, the learning aspect o...

Background: Graves orbitopathy (GO) is the most frequent and feared complication of Graves’ disease. In moderate-severe cases, intravenous (iv) glucocorticoids (GC) is the first-line treatment while Rituximab (RTX) is recommended as second-line treatment in patients non-responsive to GC. But data is scarce and contradictory.Objective: To investigate if patients with GO and poor response to iv GC benefit from a switch to RTX early in the treatment co...