Endocrine Abstracts

A 70-year-old lady with known hypothyroidism and ischaemic heart disease (previous CABG) presented with tonic clonic seizures. Her BP was 245/110. She was admitted to the intensive care unit. MRI brain showed subcortical oedema with subarachnoid bleed in the left temporal parietal region. Investigation for malignant hypertension showed a solid mass measuring 17×17×11 cm completely replacing the left kidney on CT-scanning. She was discharged home on sodium valproate w...

Bilateral inferior petrosal sinus sampling (BIPSS) is the gold standard investigation in Cushing’s disease for identifying the pituitary as the ACTH source. This technique aims to demonstrate a gradient of central:peripheral ACTH levels of >2:1 in such patients, or >3:1 after CRH stimulation. In patients without significant pituitary MRI abnormalities this facilitates neurosurgical exploration.The test is limited by difficulties in achieving...

Abstract: Generously supported by IPSEN)-->Pituitary adenomas (PA) may occur in association with malignancies. Although an increased risk of cancer has been reported in acromegalics, this has been poorly studied in patients with other phenotypes. We wished to evaluate the prevalence of recognized malignancies in PA.Material and Methods: A series of 422 consecutive PA patients followed at the Neuromed Institute ...

Background: In Clinical Trials, Glucagon-like peptide-1 (GLP-1) receptor analogs liraglutide and semaglutide have been shown to cause weight loss, reduced systolic blood pressure, effectiveglycemic control with low rates of hypoglycemia, in patients with type 2 diabetes. Through a retrospective clinical study, the authors aimed to assess the clinical effectiveness of GLP-1 receptor agonists in the management of obesity in patients with Type 2 Diabetes.Me...

Background: At diagnosis of diabetes is a critical time in the life course of diabetes. This a critical time for patient take on knowledge and using it (ref). Utilisation of this information is suboptimal due to logistical factors such as ward environment, time constraints of staff, psychological impact of the diagnosis. Current models of education are mainly didactic with limited impact in some patients.Aims: In collaboration with demontfort design unit...

Introduction: Gas chromatography/mass spectrometry based steroid profiling has been proposed as a tool for differentiating adrenocortical carcinoma (ACC) from benign adrenocortical adenoma (ACA). We retrospectively examined urinary steroid profiles from ten patients with ACC and 14 patients with ACA to determine, if the steroid profiles were predictive in distinguishing benign from malignant disease.Methods: Patients who had undergone adrenalectomy for r...

Phaeochromocytomas (PHAEOs) and extra-adrenal paragangliomas (PGLs) are rare neuroendocrine tumours. As many as 35% may have an identifiable germline mutation, most commonly in the genes encoding RET, VHL or subunits of succinate dehydrogenase (SDHx).[123I]-labelled metaiodobenzylguanidine (123I-MIBG) scintigraphy is used to localise PHAEOs/PGLs, while 131I-MIBG is used as therapy in malignant disease. Uptake of radioisot...

Case: A 41 year-old-Indian woman with type 2 diabetes treated with liraglutide was admitted to the Emergency Department with abdominal pain, nausea, vomiting and bloated abdomen. She was found to have raised amylase at 706 U/l. Abdominal ultrasound and CT scan did not reveal any abnormalities in the pancreas or billary tract and the patient was discharged.She had diabetes for 9 years duration treated with metformin, pioglitazone and liraglutide. Over 2 y...

Introduction: The diagnosis of Cushing’s syndrome (CS) can be challenging and there is no single gold standard diagnostic test. Endocrinologists rely on a combination of plasma cortisol (before and after dexamethasone), midnight salivary cortisol and urinary free cortisol (UFC) to make the diagnosis. Assessment of urinary corticosteroids and their metabolites, measured by gas chromatography–mass spectrometry (GC–MS), provide a comprehensive picture of corticoste...

Follicular thyroid cancer is the second most common cause of thyroid carcinoma. Metastasis occurs in 10–15% of cases. Typical sites of metastasis include bone and lungs, scalp metastasis are rare, with <50 cases reported. We describe two such cases.A retrospective chart review was performed on these patients, examining presentation, treatment and subsequent outcomes.Patient 1. An abnormal lesion was noted on a routine ches...