Endocrine Abstracts

Background: Determining post-operative remission in Cushing’s disease is challenging. There is no consensus for the post-operative serum cortisol value which reliably predicts remission of Cushing’s disease following trans-sphenoidal surgery. Traditionally, an early post-operative serum cortisol of below 50 nmol/L has been used to predict remission, but achieving this is often at the expense of hypopituitarism.<p class="abst...

Background: Hydrocortisone day curves (HCDCs) are commonly used to assess hydrocortisone replacement for patients with adrenal insufficiency (AI).Methods: HCDCs were obtained for 216 adrenally insufficient patients between 2004 and 2012 at Imperial College Healthcare NHS Trust. The area under the curve (AUC) was calculated for each patient’s day profile. Lipid profiles and glycated haemoglobin (HbA1c) values were recorded for each patient at both th...

Background: Glucocorticoid-induced osteoporosis is one of the major clinical concerns of long-term steroid treatment. Previous studies have shown that immunosuppressive doses of glucocorticoid can lead to osteoporosis. This study investigated whether there is a relationship between cortisol exposure and the development of osteoporosis in patients receiving replacement doses.Methods: Hydrocortisone day curves (HCDCs) performed a...

Background: Determining post-operative remission in Cushing’s disease is challenging. There is no consensus for the post-operative serum cortisol value which reliably predicts remission of Cushing’s disease following trans-sphenoidal surgery. Traditionally, an early post-operative serum cortisol of below 50 nmol/L has been used to predict remission, but achieving this is often at the expense of hypopituitarism.<p class="abst...

Prednisolone is widely prescribed in the UK, whereas prednisone is used instead for the same indications in the United States. Both have utility as anti-inflammatory agents and for use as glucocorticoid replacement therapy at lower doses. Oral prednisone is converted to prednisolone by first pass hepatic metabolism by 11 beta HSD-1. This study was undertaken to compare the bioavailability of prednisone against prednisolone. To determine the conversion of prednisone to predniso...

Introduction: Acromegaly is commonly associated with numerous cardiovascular manifestations such as left ventricular hypertrophy, hypertension and ischemic heart disease. However, initial presentation with dilated cardiomyopathy is relatively rare. Dilated cardiomyopathy in patients with acromegaly usually result from an extended and excessive exposure of the myocardium to growth hormone.Case presentation: 51-year-old female with background medical histo...

A 54-year-old man with a recurrent non-functioning pituitary gonadotroph adenoma previously treated with transphenoidal surgery (TSS) in 2015, presented to Charing Cross hospital for repeat transsphenoidal surgery in May 2022. Since his initial surgery, he remained on Levothyroxine 50 μg once daily only. There was no evidence of adrenal insufficiency (0900 h cortisol 333 nmol/l at day 6 following initial TSS). In February 2022, his electrolytes, FSH, LH, testosterone, pro...

A 57-year-old woman was referred in 2012 following an incidental finding of a pituitary macroadenoma. It measured 17×9 mm and was confined to the sella. There was no clinical or biochemical evidence of pituitary dysfunction. In 2017, she was found to have proximal myopathy, plethoric facies and purple abdominal striae. She was also on medication for hypertension and type 2 diabetes. There was no history of sleep apnoea, fractures or use of exogenous steroids. An MRI showe...

Introduction: Hyponatremia in patients with pituitary tumours are common due to many reasons including secondary hypoadrenalism and secondary hypothyroidism. When these causes are treated with the background of hyponatremia, serum sodium should be regularly monitored as it could get corrected too rapidly leading to ODS.Case report: 34 Year old patient presented to a tertiary care hospital with headache. His MRI brain revealed a large suprasellar lesion s...

Case history: We report a 56-year-old man who was referred to the Endocrinology Clinic with hypokalaemic hypertension. He had a history of bladder cancer 9-years previously, treated with surgery, chemotherapy and BCG therapy. At referral, he was taking Amlodipine 10 mg and Doxazosin 8 mg twice daily with average home blood pressure readings of 160/90 mmHg.Investigations: Aldosterone to renin ratio (ARR), taken on Doxazosin with potassium 3.6 mmol/l was 3...