Endocrine Abstracts

Adrenal vein sampling (AVS) is the gold standard for detecting aldosterone production in bilateral adrenal hyperplasia and for distinguishing the lateralization of aldosterone secretion. Successful AVS is determined by calculating the selectivity index (SI). The cut off value for the SI is ≥2.0 under un-stimulated conditions. The aldosterone level (AL) is corrected for cortisol level (CL) and adjusted values are then compared to determine the lateralizing index (LI). Mos...

Authors agree that although mortality for COVID 19 is low, comorbidities may contribute to severe disease and mortality. Chinese center for disease control and prevention reported three times higher mortality in patients with diabetes. However, most studies do not take into account age of patients. Our study aimed to evaluate association of COVID in patients lesser than 65 years of age in two countries, India and United Kingdom with diabetes. We excluded patients with co-morbi...

The goals of treatment for a prolactinoma are to normalise serum prolactin and decrease the size of the tumour. Dopamine agonists (cabergoline is first-line) represent primary therapy for almost all prolactinomas. Some prolactinomas exhibit resistance to dopamine agonist treatment and require higher doses. Our patient was a 35-year-old male who presented to Ophthalmology in March 2021 with visual disturbance, confirmed to be secondary to a bitemporal hemianopia. OCT showed bil...

Background: Mrs X had experienced severe right sided abdominal pain. Brought to hospital by ambulance from the residential home. In Accident and Emergency, she was confused and the accuracy of her history was difficult to confirm. Mrs X had a CT abdomen and pelvis with contrast. This had reported a 3.8 cm enhancing, well defined left adrenal mass, this needed to be assessed with adrenal protocol CT. Referred to Nurse-Led Adrenal Incidentaloma clinic for investigations.<p c...

Introduction: Intra thyroidal parathyroid adenoma is an uncommon presentation of primary hyperparathyroidism (PHPT). Herein we report such a patient who had recurrent hypercalcemia after a classical parathyroid exploration.Case presentation: 45 year old female, home-maker had a long standing history of weakness, back and lower limb pain, loss of appetite. Preliminary evaluation at secondary care level revealed hypercalcemia (18.3 mg/dl) with high intact ...

Background: Combination peptide receptor radionuclide therapy (PRRT) with the multikinase inhibitor cabozantinib may result in enhanced tumor response and improved intratumoral delivery of Lu-177 DOTATATE by normalization of tumor vasculature through VEGFR inhibition.Methods: In a phase Ib trial, patients with advanced somatostatin receptor (SSTR) positive, G1-3 neuroendocrine tumors (NETs) with a Krenning score of >2 are treated with 4 x 8 week cycl...

We present a case series of patients admitted to our hospital with various manifestations of Cushing’s. 71 male, known type 2 diabetes, hypertension referred for adrenal incidentaloma. Cushingoid features with non suppressed ACTH. Low dose dexamethasone test (LDSST): no suppression. 4 cm pituitary microadenoma (likely co-secretory as gonadotropins elevated). Offered IPSS and pituitary surgery. Declined the same due to fears of COVID opted for medical therapy with metyrapo...

Case history & Management: A 36-year old lady of Lithuanian descent first presented in 2011 with secondary infertility due to hyperprolactinaemia of 1554 (N=0–500). Her MRI was normal and was started on Cabergoline which was stopped 5 months later when she became pregnant. She delivered normally but was thereafter lost to follow-up. She was referred back in 2014 with galactorrhoea and hyperprolactinaemia (6856) and MRI this time showed a 0.7 mm microprolactin...

Introduction: Foetal adrenal haemorrhage is relatively rare with a reported incidence of 0.2% in neonates. We share our experience of two neonates who were diagnosed to have adrenal haemorrhage in our centre over last 5 years. We also carried out a retrospective review of literature on existing evidence regarding diagnosis and evaluation of neonates with adrenal haemorrhage.Methodology: Two neonates with confirmed adrenal haemorrhage were identified from...

Traditional literature agrees that Diabetic Ketoacidosis is typically associated with Type 1 Diabetes Mellitus, but can be associated with stress including infections in Type 2 diabetics. The authors did a restrospective evaluation of diabetic ketoacidosis presenting to a large district hospital in London. 343 patients were admitted with diagnosis of Diabetic Ketoacidosis during the COVID peaks from January 2020 to January 2021. 57% of these were Type 1 diabetics and 43% were ...