Endocrine Abstracts

Background: Pituitary adenomas commonly present with palsies involving the cranial nerves in the cavernous sinus. It is unusual, however, for other cranial nerve palsies to co-present and to have biochemical results that do not fit with the clinical picture.Case: A 47 year old man was admitted with 3 days of headache, vomiting, right sided facial paraesthesia and facial droop. He had no symptoms suggestive of endocrine disturbance. Neurological examinati...

Introduction: An insulinoma is a rare neuro-endocrine tumour originating in the pancreatic beta-cells with unregulated secretion of insulin resulting in profound hypoglycaemia.Methods: A search of electronic hospital records identified all patients with a primary diagnosis of insulinoma. Clinic and discharge letters, radiology investigations, laboratory investigations and case notes were reviewed to highlight the presentation, investigations and laborato...

The guidelines for the treatment of pituitary apoplexy have now been published in Clinical Endocrinology (Clin Endocrinol 2011 Jan;74(1):9–20). These resulted from a group set up during the London pituitary multidisciplinary meeting.Classical pituitary apoplexy is a medical emergency and rapid replacement with hydrocortisone maybe life saving. It is a clinical syndrome characterised by the sudden onset of headache, vomiting, visual imp...

Aims: Our aim was to explore factors related to the acute presentation of diabetic keto-acidosis (DKA) in patients with Type 2 diabetes mellitus (T2D), and to identify any predictors for severity of DKA in T2D.Methods: This was a retrospective study based on acute medical admissions presenting to the Royal Berkshire Hospital during 2008. Criteria for inclusion included a confirmed diagnosis of DKA (defined by a plasma glucose level >11.1 mmol/l, keto...

Case: A 69 year old man was diagnosed with poorly differentiated pancreatic adenocarcinoma with liver metastases in November 2017 and received FOLFIRINOX chemotherapy followed by Gemcitabine. This stabilised his disease and chemotherapy was stopped in March 2020. In April 2021 he presented with a 3-4 month history of tiredness; intermittent confusion, especially in the early morning; the discovery that food resolved his symptoms, albeit temporarily; and accompanying significan...

Introduction: There are patients who remain symptomatic with hypothyroidism despite apparent adequate replacement on levothyroxine (LT4) therapy. We present an observation where monozygotic twins responded only to combination therapy with liothyroinine (LT3), and were found to have a genetic variation which may have clinical significance in thyroid metabolism.Case report: A 47-year-old female with polyglandular auto-immune syndrome (APS1) presented with ...

Background: World Gastroenterology Organisation (WGO) quotes gallstones prevalence of 9-21%, incidence of 0.63/100 persons/year in Europe; 10-15% of UK population have gallstones (1). Acromegaly patients’ prevalence is 8.3% and 35% developing incidental gallstones during somatostatin analogue (SSA) treatment (2).Objective: To evaluate the prevalence of gallstones in SSA treated Acromegaly patients in University Hospitals of Leicester (UHL).<p cl...

Introduction: There is a clinical need to develop better biomarkers for the monitoring of patients with neuroendocrine tumours (NETs), including for patients with multiple endocrine neoplasia (MEN). Chromogranins are widely used, as are individual hormones for specific syndromes. Neurone specific enolase (NSE), however, is measured less commonly and its utility is debatable.Aims: To assess the value of measuring NSE in the clinical management of patients...

Thyroid cancer is the most common endocrine malignancy accounting for 1% of new cancer cases each year. Even after treatment, one in five patients develop recurrence eventually. Therefore, close follow up is crucial after treatment. Current tumour biomarkers are not perfect, and there is a need for a more sensitive and specific way of detecting early recurrence. Liquid biopsies have emerged as a novel marker in tumour surveillance and monitoring response to treatment. In parti...

Introduction: Meningiomas are the most common brain tumours and they express progesterone receptors. Cyproterone acetate (CPA) is a synthetic progestogen approved for use as an anti-androgen in Polycystic Ovarian Syndrome (PCOS). We report a case of meningioma probably resulting from long-term CPA treatment and a review of our PCOS cohort for further cases.Case report: A 47-year-old lady with PCOS was treated with CPA 100 mg once daily for hirsutism and ...