Endocrine Abstracts

Case summary: A 40 year-old lady, who has a background of asthma, presented to emergency department with back pain radiated down to her left leg with associated foot drop. She also complained of 2 months history of weight gain, hirsutism, and menstrual disturbance. Clinical examination confirmed that she had some cushingoid features. Further assessment and investigations revealed that she had acute disc prolapse on MRI as well as an incidental finding of right adrenal gland an...

Background: Primary hyperaldosteronism (PHA) is characterised by inappropriately high aldosterone production, most commonly caused by unilateral/bilateral adrenal adenoma or bilateral adrenal hyperplasia. It usually manifest as hypertension and/or hypokalaemia. There is emerging evidence to support the prevalence of PHA in more than 10% in hypertensive patients but only a minority will have a confirmed diagnosis and receive specific treatment.Aim: To pro...

Autonomous cortisol secretion (ACS), a term that refers to biochemical evidence of excess cortisol, but without the overt Cushing’s syndrome in people with adrenal adenomas. Prevalence of adrenal tumours is 5-10%. Up to 50% of benign adenomas present with some degree of cortisol excess. There is little guidance for investigating and managing these patients leading to different standards of care. Cortisol secretion here is in wide range although post dexamethasone suppress...

Introduction: Traditionally the long synacthen test (LST) is used in some centres to assess hypothalamic/ pituitary and adrenal (HPA) axis. Evidence that it offers advantage over short synacthen test (SST) is lacking. Whilst changing our local protocol we evaluated 27 patients who had both tests in our trust. We compared the impact of the results in clinical decision making.Results: Mean age was 53 years. The indications for th...

Introduction: Traditionally the long synacthen test (LST) is used in some centres to assess hypothalamic/ pituitary and adrenal (HPA) axis. Evidence that it offers advantage over short synacthen test (SST) is lacking. Whilst changing our local protocol we evaluated 27 patients who had both tests in our trust. We compared the impact of the results in clinical decision making.Results: Mean age was 53 years. The indications for th...

Introduction: Phaeochromocytoma (PHAEO) and paraganglioma (PGL) are neuroendocrine tumors arising from neural crest-derived cells either in the adrenal gland (PHAEO) or along the central sympathetic and parasympathetic chains (PGL), including the carotid body. There is convincing evidence linking hypoxia pathways with development of PHAEO/PGL especially with genetic susceptibility. Association between PHAEO and PGL and cyanotic congenital heart disease (CHD) are well recognise...

Background: Evidence shows relative adrenal insufficiency is one of the complications known to be associated with major procedures such as cardiopulmonary bypass surgery or critical illness. This is the first case we are presenting someone with acute hypoadrenalism following post thrombin injection to treat pheudoaneurysms.Case: We present an interesting case of 55 years old man with known decompensated alcoholic liver disease with oesophageal varices, p...

Introduction: Adrenal incidentalomas are increasingly found in patients imaged for investigation. A service evaluation was undertaken to standardise care for these patients in line with the European Society of Endocrinology Guidelines.Aim: Standardise the care for patients with adrenal adenomas at Royal Liverpool University Hospital.Method: Retrospective review of 70 patients with adrenal incidentalomas over 2 years (January 2016&#...

Introduction: Adrenal incidentalomas are common occurrence with up to 3–10% of the general population who have imaging. Up to 20% of them may have autonomous cortisol secretion (ACS), a term that refers to biochemical evidence of excess cortisol, but without the overt cushing’s syndrome.Aim: Prevalence of ACS in our cohort of patients with adrenal incidentalomas and review their care.Method: Retrospective review of 70 pat...

Pseudohypoparathyroidism (PHP) is highly heterogeneous rare disorder characterized by end organ resistance to PTH action with proven genetic component. PHP-Ib classically refers to a condition characterized by renal resistance to PTH in the absence of other endocrine or physical abnormalities and in the presence of a normal GNAS alfa activity and only few cases have been reported so far. We report a case of 43 year old gentleman was diagnosed to have seizures at the age of 13 ...