Endocrine Abstracts

Case history: Patient 1, a 78 year old male, was diagnosed five years ago with a metastatic NET with octreotide avid disease including ileocolic/right common iliac nodal metastases and a solitary segment VII liver lesion. He elected for watchful waiting and was asymptomatic. Interval imaging showed gradual local disease progression. He was diagnosed with motor neurone disease resulting in unilateral arm weakness. He re-presented four years after diagnosis with progressive weak...

Case history: 52 year old gentleman presented in 2013 with a 1 year history of abdominal pain. Imaging to screen for gallstones identified a large adrenal mass which was radiologically suspicious for adrenal carcinoma with probable inferior vena cava (IVC) involvement.Investigations: Overnight dexamethasone suppression test (ONDST) failed to suppress cortisol (324 nmol/l) with undetectable ACTH (<5 ng/l). Failure of suppression on low dose dexamethas...

At high latitudes over-wintering personnel are deprived of natural sunlight in winter: light of sufficient intensity and suitable spectral composition is the main factor which maintains a 24 h period in human circadian rhythms. Numerous reports of sleep problems from Polar regions prompted investigations of the underlying mechanisms. At Halley (British Antarctic Survey Base, 750S) the sun does not rise for 3 months in winter and a delay of the melatonin rhythm is observed. Thi...

Light of sufficient intensity and suitable spectral composition is the main factor which maintains a 24 h period in human circadian rhythms. At the British Antarctic Survey base of Halley (75 °S) the sun does not rise for 3 months in winter and does not set for 3 months in summer. In this isolated environment most subjects remain synchronised to the 24 h day however the melatonin rhythm and sleep are delayed in winter compared to summer. Summer timing can be restored with...

Background: Familial male-limited precocious puberty (FMPP) or ‘testotoxicosis’ is a rare form of gonadotrophin-independent precocious puberty. There is a paucity of data on final adult height in these patients and no consensus on what constitutes appropriate treatment. Our aim was to assess the management and final height of patients with FMPP under our care as well as those reported in the literature.Methods: Growth data were obtained from no...

Background: Type 1 diabetes mellitus is an autoimmune condition resulting in insulin deficiency, causing both long and short term complications. The Diabetes Control and Complications Trial (DCCT) demonstrated that tight glycaemic control and consequent lower HbA1c values reduced the risk of long-term complications. This can be achieved using multiple daily injections (MDI) or newer continuous subcutaneous insulin infusion (CSII) therapy. This is recommended by NICE for those ...

Introduction: Testotoxicosis and other causes of precocious puberty can result in compromised final adult height and various treatments have been used in an attempt to address this. We report final height data in children with testotoxicosis who were treated with a variety of regimens and who have attained/are predicted to attain, a final height in excess of the mid-parental target.Patients and methods: Growth data from four patients with activating muta...

Introduction: PATRO children is an international, non-interventional, longitudinal study of the long-term safety of a biosimilar recombinant human growth hormone (Omnitrope, Sandoz). In particular, the study assesses the diabetogenic potential of Omnitrope and the risk of malignancies. The long-term efficacy is a secondary objective of the study. Here we present safety and efficacy data of UK patients recruited since 2008, following an interim analysis in May 2017.<p class...

Background: Adrenal tumours are often benign and non-functioning. However, there can be underlying phaeochromocytoma, Conns, adrenal Cushing or even malignancy in some cases. It is therefore imperative that these incidentalomas are promptly investigated once detected and managed accordingly.Aim: 1. To determine the incidence of adrenal incidentaloma at Gozo General Hospital. 2. To determine the adherence of management of incidentalomas to guidelines reco...

Introduction: The commonest pathological cause of goitre in adolescence in the UK is autoimmune thyroid disease. Other thyroid pathologies may occasionally co-exist either linked to the autoimmune process or occurring together by chance.Case report: A previously fit and healthy 15-year-old male presented as an emergency with a 10-day history of painless neck swelling. He had no breathing difficulty, dysphagia or voice change and was also clinically euthy...