Endocrine Abstracts

History: A 54 years old gentleman was admitted to the hospital after being found unconscious at home by his wife with a tongue bite and urinary incontinence. He had perineal approach biopsy 2 days ago for prostate cancer. Since biopsy, he had poor urine output with clots and dribbling. He also gave 2 days history of constipation. Wife was a doctor and mentioned that she palpated a distended bladder the night before. On examination, he was haemodynamically stable although he di...

Introduction: Thyroid Storm is a life-threatening but rare (incidence 0.2 per 100 000) disease state which presents as an extreme form of thyrotoxicosis. A hyper-metabolic state resulting from excessive thyroid hormone release which can be precipitated by both thyroidal and non-thyroidal illness.Case: In this case we discuss a 72 year old female with previously treated Graves disease who presented in thyroid storm one week after annual flu vaccination. O...

Introduction: Localising the aetiology of Cushing’s syndrome can be challenging, especially when investigations utilised are limited in their sensitivities and specificities. We present a case whereby the reliabilities of laboratory and radiological investigations are tested to their limits.Case Presentation: A 70 year old female presented with a one year history of fatigue, weight gain and headaches. She had proximal myopathy, cheek telangiectasia ...

Background: Hypogonadism in males is associated with a reduction in bone mineral density (BMD). It is known that the reversal of this is achievable through adequate hormone replacement; however, the degree to which this is dependent on the proportion of time patients spend within the recommended therapeutic range (>15 nmol/l) in real-ife has not yet been established.Aim: To evaluate the degree to which the proportion of time that a hypogonadal p...

BackgroundThyrotropin Stimulating Hormone Suppression Therapy (TSHST) in Differentiated Thyroid cancer (DTC) patients can result in reduced bone mineral density (BMD) which is a potential serious problem [1]. Studies on the effects of TSHST on BMD have demonstrated conflicting results [2–5]. There is insufficient guidance regarding the degree and duration of TSHST in the context of skeletal effects despite multiple existing guidelines.<p class="...

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&#...