Endocrine Abstracts

A 64-year-old lady presented with weight gain, tiredness, palpitations and tremor. She had no goitre and no other extra thyroidal manifestations. Both TSH and thyroid peroxidase antibodies (>1300) were elevated and she was treated by her GP with Thyroxine 50 mcg daily. She felt a lot worse on this, so it was discontinued and a full thyroid hormone profile was checked (see Table 1) which prompted referral; to Endocrinology.Other pituitary hormone leve...

Phaeochromocytomas (PCC) are rare neuroendocrine tumours of chromaffin cells that are characterised by autonomous production of catecholamines. Fundamental to the detection and diagnosis is the biochemical confirmation of excessive catecholamine production by the measurement of plasma or urinary catecholamines and metanephrines. Recently, plasma metanephrines have been shown to provide a high diagnostic sensitivity for the detection of catecholamine secreting tumours and unlik...

A 69-year-old woman was admitted with new uncontrolled diabetes, severe hypertension and bilateral leg oedema. Cushing’s syndrome was suspected when she developed resistant hypokalemic alkalosis on diuretic therapy. Detailed questioning also revealed a history of episodic sweating, palpitation and tremor.Investigation & management: ACTH-dependant Cushing’s syndrome was confirmed: Serum ACTH 516 ng/l; urine free cortisol 20 045 nmol/24 h; 09...