Endocrine Abstracts

Lung cancer is the second most common cancer in the world with the leading position as a cause of oncological fatality. The immunotherapy is applied as the second line of chemotherapy, and seems a breakthrough therapy, promising a better quality of life to patients in the late stages of cancer. Pembrolizumab (also, known as MK-3475 or Keyruda) is a humanised antibody PD-1 receptor or antibody to programmed death ligand one. Side effects considered as acceptable and mostly pres...

Pancreatic Neuroendocrine tumours, P-NETs, comprise 2–3% of all pancreatic tumours. Usually classified as functional or non-functional based on whether these secrete biologically active amines, causing specific syndromes or not. Even non-functional P-NETs in majority of cases secrete substances, not associated with any specific syndrome, like Chromogranin A and Chromogranin B and Pancreatic Polypeptide (PP). An estimated 2% of all the neuroendocrine tumours secrete Pancre...

Controversy exists as to the best way to determine which thyroid nodules we should have fine needle aspiration (FNA). The lack of consensus in the British and American Thyroid Association guidelines has not helped to clarify this. The use of ultrasound scan (USS) determined U grading versus a composite of nodule size and pre-determined number of suspicious features continues to be debated. We therefore set out to compare the accuracy of U grading with other identified USS feat...

Background: Short synacthen test is used to assess adrenal function by injecting 250 μg of synacthen (tetracosactide) and measuring cortisol at baseline and subsequently after 30 and 60 min of the injection. In our hospital the cut-off for a normal test is a peak cortisol of 480 nmol/l or an increment of 200 or more from the baseline value.Methodology: We reviewed the results of 50 short synacthen tests performed in our hospital within the last year...

TSH receptor antibodies (TRAB) are now routinely measured in patients with Graves’ disease (GD) to aid diagnosis. Thyroid peroxidase antibodies (TPO) sometimes co-exist in these patients but not always. Some studies have suggested a functional and prognostic role for these antibodies. However, the phenotypic characteristics of the patient with positive TPO (with or without TRAB) and the influence of TPO on the clinical course of GD are not known.A r...

The use of anti-thyroid medication is favoured first line therapy in Graves’ disease (GD). However, relapse rates are high (up to 50%) and definitive therapies of either surgery or radioactive Iodine therapy (RAI) are often considered following an informed decision. The definitive choice taken depends on several factors considered during the patient-doctor interaction. The aim of this study was thus to determine the influence of such factors.A cross...

Hypopituitarism is a recognised complication of pituitary and hypothalamic pathology. It can also be a consequence, less commonly, of traumatic brain injury. It has never been described in patients following recovery from a cardiac arrest. We present a case history of hypopituitarism following successful cardiopulmonary resuscitation for a ventricular tachycardia (VT) cardiac arrest. A 51 year old patient with known prolonged QT (Romano ward) syndrome and chronic obstructive a...

Introduction: The symptoms and signs of thyroid disease can be subtle and non-specific resulting in the indiscriminate use of thyroid function tests (TFT) for diagnosis. The resulting rise in the number of TFTs has raised issues about cost–effectiveness of such a practice. We set out to identify whether using specific clinical indications was an effective way to identify patients with abnormal TFTs and to determine any demographic data that would support unrestricted TFT ...

Background: Adrenal incidentalomas often pose a clinical conundrum when identified radiologically. The direction of management is often based on findings on imaging and biochemistry. To aid management, the European society for Endocrinology (ESE) recently published guidelines. Aims and Methods: We conducted a retrospective analysis of 142 patients with identified adrenal incidentalomas between April 2020 and April 2021 in East Kent Hospitals University N...

Widespread use of CT and MRI scan has led to the identification of incidental adrenal tumours. The need to determine functionality often results in a battery of investigations that are a drain to scarce resources and are frequently normal. Studies to identify tumour radiological features that suggest functionality and hence enable targeted investigations are few in the literature. To this effect we set out to analyse which features on imaging that are best predictive of functi...