Endocrine Abstracts

We report two cases of seizures resulting from severe electrolyte imbalance.Case 1: A 48-year old lady with CREST syndrome and oesophageal dysmotility. She was admitted with diarrhoea and vomiting. Routine investigations including FBC, U&E, LFT, and CRP were normal. She later complained of pins and needles in her hands and around her mouth. Twenty-four hours later, she developed blurred vision, neck pain and generalised ache, was found drowsy, with p...

Introduction: We present 3 cases of the same severe electrolyte imbalance presenting with acute neurological symptoms.Case descriptions: Case A, a 48 year old lady with severe CREST syndrome presented with prolonged vomiting and diarrhoea. Initial investigations showed: Sodium 141 mmol/l, Potassium 3.2 mmol/l, Creatinine 53 mmol/l, Glucose 4.3 mmol/l, Haemoglobin 13.9 g/dl, Albumin 38 g/l. 2 days after admission she developed seizures. Case B, a 75 year ...

Objective: Propylthioracil (PTU) when given long term has recently been implicated in the development of antineutrophil cytoplasmic antibody (ANCA) related systemic vasculitis. We describe a case of ANCA positive athropathy induced by long term PTU therapy. Methods: Assessment was based on patient's symptoms, signs, serum markers and treatment outcome as revealed by case notes and patient review. A Medline search for PTU related vasculitis was also performed. Results: A 27-yea...

We report 28 patients (21M 7F; 17-86y) with pituitary apoplexy presenting between 1988 and 2004. Presenting features included: headache in 25 patients, 'collapse' in 3, vomiting in 13, complete blindness in 4, decreased visual acuity in 13, visual field loss in 12 and ophthalmoplegia in 16. Only 4 had no initial visual deficit. Predisposing factors included a known pituitary tumour in 4 patients, anticoagulant therapy in 3 patients and ITP in 1 patient. CT was initial imaging ...

Introduction: Accumulating evidence suggests an association of vitamin D with insulin resistance (IR) in women with polycystic ovary syndrome (PCOS). The role of PTH in insulin metabolism is less clear. We aim to study the association of PTH and 25-hydroxyvitamin D (25(OH)D) levels with metabolic and endocrine parameters in a cohort of PCOS women.Methods: We measured PTH and 25(OH)D levels in 544 PCOS and 139 healthy control women within the same age ran...

Introduction: Pheochromocytomas represent rare but potential lethal tumors arising from the adrenal medulla. Early recognition and diagnosis represent a challenge due to the non-specific character of signs and symptoms. The classic presentation includes headache, sweating, palpitations and other signs and symptoms of apparent catecholamine excess occurring in paroxysms. Sympathomimetics may result in a similar presentation, potentially complicating the diagnosis.<p class="...

Background: Transformation of the South Wales NET service in late 2017 introduced new specialised staff, gastroenterology-led clinics and MDTs with a particular emphasis on educating referring specialties on NETs. Data has shown patient experience, satisfaction rates, quality of life and gastrointestinal symptom scores have all improved. This study aims to describe findings from new NET service data for: referrals into the service, diagnosis times after symptoms, and initial s...

Background: Confirmation of primary aldosteronism (PA) with the saline infusion test (SIT) requires accurate measurements of plasma aldosterone, best achieved by mass spectrometry. Performance of the test and appropriate cut-offs remain inadequately defined.Design and methods: This prospective multicenter cohort study involved 451 patients with suspected PA who underwent a seated SIT. Among these, there were 90 and 76 in whom PA was respectively confirmed and excluded based on...

Background: Diagnostic stratification of patients with suspected primary aldosteronism (PA) is a multistep process reliant on tests that are not infallible. Only through prospective studies can diagnostic accuracy be appropriately assessed.Methods: The PROSALDO trial enrolled 819 patients between 2019 and 2023 to assess steroid profiles against routine tests for diagnostic stratification. A combination of these tests and outcome assessments, including me...

Background: Primary aldosteronism (PA) is the most prevalent cause of secondary hypertension. Its two main clinical forms are unilateral adenoma (APA) and bilateral hyperplasia (BAH), which require markedly different medical treatments, so differentiating between the two is of utmost clinical importance. The current gold standard method for this is adrenal vein sampling (AVS), the application of which is hindered by limited availability and high skill requirements.AimOur goal ...