Endocrine Abstracts

Introduction: ACTH deficiency is life-threatening, but difficult to differentiate from ACTH suppression especially in children and young people (CYP) receiving perioperative corticosteroids for pituitary tumour surgery. In our experience, ACTH is the most, and GH the least robust anterior pituitary hormone, with LH/FSH and TSH intermediate in hierarchical loss.Aims: To assess potential misdiagnosis of ACTH suppression versus deficiency and time to adrena...

Introduction: We wanted to assess whether our report of better adherence to GH therapy using jet (ZomaJet) rather than needle delivery in a large nationwide cohort, translated into better growth outcomes.Aims and hypothesis: To retrospectively audit growth markers in our local split-site (GOSH/UCLH) cohort of children, starting GH using Zomajet between 01.01.2010 and 31.12.2012, for whom we had previous adherence (PDC) scores.Metho...

Case Presentation: A 27-year-old female who recently moved to the UK, was referred to Endocrinology with suspected thyrotoxicosis. She was diagnosed with thyrotoxicosis 11 years prior, and was temporarily treated with a ‘block and replace’ regimen. She had history of traumatic brain injury with no long-term sequelae, and cholecystectomy leading to chronic diarrhoea. She reported swallowing difficulty and a choking sensation. Investigations identified hyperthyroidism ...

Sclerotic bone lesions are a rare cause of hypocalcaemia. Calcium and vitamin D malabsorption are recognised complications of gastric bypass surgery. We describe the case of a 45 year-old woman with severe persistent symptomatic hypocalcaemia secondary to metastatic breast cancer, complicated by a previous Roux-en-Y gastric bypass, and the development of hypoparathyroidism. Her corrected calcium levels fell repeatedly and precipitously despite treatment with up to 8g/day oral ...

Introduction: Saliva hormone measurements are increasingly being applied in every day clinical practice. In relation to salivary cortisol/cortisone measurement there is a particular advantage, with minimal chance of cross reaction with prescribed glucocorticoids. We here evaluated the utility of these measurements in patients undergoing an overnight (1 mg) dexamethasone suppression test (ONDST).Methods: A service evaluation of salivary cortisol/cortisone...

Background: The short synacthen test (SST) is the most commonly performed investigation to assess for suspected adrenocortical dysfunction. We investigated how random cortisol levels may relate to pass/fail on the STT.Methods: We analysed the relation between random cortisol measurements taken between 04.40 and 20.52 in the day and results of SST baseline and 30/60 min cortisol performed over a 12 month period (338 SSTs) at Salford Royal Hospital. Serum ...

Introduction: Adverse neurodevelopmental outcomes have been recognised in children with hypoglycaemia due to early and late presenting congenital hyperinsulinism (CHI). The Vineland Adaptive Behaviour Scales II (VABS-II) is a standardised measure used to assess parent reported adaptive behaviour. The test measures five domains; motor, communication, daily living skills (DLS), socialisation, and maladaptive behaviour. We have used VABS-II to identify specific neurodevelopmental...

Background: Congenital Hyperinsulinism (CHI) is a disease of severe hypoglycaemia due to insulin hypersecretion, that can be recognised either early or late in childhood. CHI is associated with adverse neurodevelopmental outcomes. The Vineland Adaptive Behaviour Scales Second Edition (VABS-II) is a parent-report measure of intellectual and developmental functioning, which could be used to screen children with CHI for impairments.Aims: To investigate reli...

Phaeochromocytoma-driven Ectopic ACTH Syndrome (EAS) is rare. We report the case of a 31-year-old female, who presented with abdominal pain and vomiting. She had clinical features of severe Cushing’s syndrome (proximal myopathy, bruising, refractory hypertension and acute confusion). Admission investigations revealed hypokalaemia (2.1mmol/l [3.5-5.5mmol/l]) and a 4.5cm left adrenal lesion with a ’bulky’ right adrenal on CT abdomen. She was diagnosed with hyperte...

Objectives: In 2010 we piloted a national multidisciplinary (MDT), meeting virtually to improve management of rare suprasellar (HPAT) tumours. In 2014 we reported centralised treatment decision-making in craniopharyngioma and now wished to examine whether centre based management of idiopathic thickening of the pituitary stalk (iTPS) differs and can be streamlined by wider debate. This might also inform current commissioned BSPED and CCLG guidance.Methods...