Endocrine Abstracts

The prevalence of adrenal incidentaloma on abdominal Computed Tomography (CT) is around 4.4%. This prevalence is increased in obese, diabetic, hypertensive patients, and could be as high as 10% in older patients. Unilateral adrenal masses larger than 4 cm should be considered for surgical removal to avoid missing adrenal carcinoma, particularly in younger patients.This is the case of a 67 year old gentleman with Type 2 diabetes mellitus, known to have hy...

Current UK guidelines for thyroid nodules advise a thyroid ultrasound (ThyUSS) with U-Classification with or without Fine Needle Aspiration (FNA) with Thy-Classification to determine malignancy risk. We report four cases where thyroid carcinoma was diagnosed histologically following reassuring cytology and radiological examination. This is a case of 28-year-old female who presented with neck swelling. ThyUSS showed an enlarged left thyroid with cystic and solid components; FNA...

Background: Despite the widespread use of the 250-μg Cosyntropin test (ACTH test) for the diagnosis of adrenal insufficiency (AI), the effect of timing of the test on 30- vs. 60-min serum cortisol values remains unclear. Also, there is limited evidence comparing the value of performing both 30- and 60-min cortisol levels.Methods: We conducted a retrospective cohort study of all ACTH tests conducted at the Halifax Neuropituitary Program, Nova Scotia,...

Introduction: Thyroid cancer is the most common malignant endocrine tumour and represents 1% of all malignancies. Cancer Research UK in 2015 reported 3528 new cases and 382 deaths with annual incidence of 5.1 and 1.9 per 100,000 women and men respectively. The incidence is increasing globally, mostly due to papillary thyroid cancer.Ultrasound is the preferred examination with recommended U1-U5 grading system +/- fine-needle aspiration cytology (FNAC)...

The guidelines for management of prolactinomas (PRLoma) during pregnancy are mostly based on retrospective evidence or expert opinion. We conducted a survey of four Canadian provinces (NS, NB, PEI and BC) to assess the current trends in management of PRLoma during pregnancy. A case-based electronic questionnaire was sent to all practicing endocrinologists, with 3 cases of varying severity ranging from a micro PRLoma to a large macroPRLoma compressing the optic chiasm. A total ...

Aims/hypothesis: Resistin could be implicated in the mechanism of insulin resistance and recent evidence suggests this occurs, in part, via a brain-dependent pathway. Given the emerging role of hypothalamic AMP-activated protein kinase (AMPK) in the modulation of appetite and glucose levels, we hypothesized that its activity would be modulated by resistin. To verify such a pathway, we employed the N-1 hypothalamic neuronal cell line, which expresses a variety of neuropeptides ...

We report a case of a 43 year old lady who was referred by her general practitioner (GP) to the endocrine team with an 8 month history of extreme fatigue, difficulty losing weight, galactorrhoea and mild breast enlargement. She has two children aged 16 and 14, all well. Her background medical history included depression, asthma and hysterectomy for fibroids 3 years ago. Examination of all systems were unremarkable including visual fields to confrontation, fundoscopy and full n...

Introduction: While there is a significant risk of recurrence in nonfunctioning pituitary adenoma (NFPA) after surgery, it is challenging to predict which NFPAs will recur based solely on routine histopathology. To better understand markers of recurrence, we assessed the established tumor markers linked to aggressive tumor behavior including X-linked IAP (XIAP), the most potent inhibitor of the apoptosis protein family, vascular epithelial growth factor (VEGF) which facilitate...

Patients with acromegaly (PWA) experience higher rates of falls and fall-related injuries than age-matched Canadian adults. Previous studies of standing balance revealed increased sway in PWA compared to healthy controls but failed to control for the effects of the pituitary adenoma. Therefore, the aim of the present study was to determine if acromegaly influenced the neuromuscular control of standing balance. Bipedal standing balance was evaluated in PWA (n=13) in bi...

Acromegaly triggers, and is associated with, peripheral nervous system modifications and joint degenerations, which are considered to impact the walking balance of patients with acromegaly (PWA). Therefore, to better understand if these systemic degenerations impact the transitory adaptations in locomotor patterns of these patients, this study aims to establish the walking balance deficits of PWA. Walking balance was evaluated in PWA (n=8) in biochemical remission and...