Endocrine Abstracts

A 44 year old woman presented in November 2000 with a two week history of headaches, vomiting and blurred vision. Past history consisted of type 2 diabetes and migraine. Initial investigation revealed hyponatraemia (sodium 114 mmol/l) and deranged liver biochemistry. ANA, anti dsDNA, cANCA, pANCA, anti Ro, La, RNP, Scl-70, Jo-1, smooth muscle and mitochondrial antibodies were negative. MRI revealed a 13x18x15mm pituitary mass elevating the optic chaism, without evidence of rec...

In laboratories employing 'front-line' sensitive TSH measurement, it is generally accepted that fully suppressed TSH levels (3rd generation assays) alongside normal free thyroid hormone levels indicate subclinical hyperthyroidism. However, low but not suppressed levels are often labelled as non-thyroidal illness.We investigated 25 successive ambulant individuals, identified over an 18 month period as having low but not fully suppressed TSH levels (3rd ge...

BackgroundCushing’s disease (CD) is caused by high levels of blood cortisol resulting from excess secretion of adrenocorticotropic hormone (ACTH) from an anterior pituitary corticotroph adenoma. Clinical manifestations include diabetes, hypertension, osteoporosis, and depression. If untreated, CD has an increased mortality of five-fold owing to cardiovascular comorbidities, stroke or raised vulnerability to infection. Currently, transsphenoidal surg...

Background: Mild autonomous cortisol secretion (MACS) in patients with adrenal incidentalomas has been associated with elevated cortisol levels during the nocturnal period resulting in a disturbed cortisol rhythm. We hypothesised that administration of nocturnal metyrapone, an 11-beta-hydroxylase inhibitor, previously shown to restore cortisol rhythm in MACS patients, could reduce metabolic complications in this patient group.Met...

Introduction: Risk of thyroid cancer is 17-32% in cold nodules and <1 % in hot nodules. Hot nodules are usually associated with Thyrotoxicosis. Patients with thyroid carcinoma are usually euthyroid but may be associated with hypothyroidism. We report 3 patients with hyperthyroidism and associated thyroid carcinoma.Case 1: A 17 years old lady presented with a lump in the neck and examination revealed prominent nodule on the right. TFTs were suggestive...

Background: Hyponatraemia is a common electrolyte abnormality that is associated with significant morbidity and mortality in patients admitted to hospital. Fluid restriction is the recommended treatment option for syndrome of inappropriate antidiuretic hormone secretion (SIADH), a common cause of hyponatraemia with limited evidence for alternative treatment options. The aim of our study was to share the experience of our hospital in the successful management of SIADH where we ...

Introduction: Incompletely controlled acromegaly has a three-fold excess all-cause mortality, with stroke being the predominant cause of death. Debate exists about the relationship between fractionated radiation (FRT) and risk of stroke, with radiation damage to cerebral vasculature potentially being a cause. We present outcomes in patients treated by gamma knife STRS at the National Centre for Stereotactic Radiosurgery in Sheffield, with...

Introduction: Incompletely controlled acromegaly has a three-fold excess all-cause mortality, with stroke being the predominant cause of death. Debate exists about the relationship between fractionated radiation (FRT) and risk of stroke, with radiation damage to cerebral vasculature potentially being a cause. We present outcomes in patients treated by gamma knife STRS at the National Centre for Stereotactic Radiosurgery in Sheffield, with...

Background: Liraglutide is a glucagon-like peptide analogue recently approved for use in children and young people for treating obesity. It is recommended for use within multidisciplinary weight management services, alongside dietetic and lifestyle interventions, in children over 12 years with severe obesity.Aim: To describe our experiences of using liraglutide in a tier 3 paediatric obesity service in a patient cohort who had previously failed to succes...

Background: Cushing’s syndrome (CS) is estimated to have a 10-fold increased risk of venous thromboembolism (VTE) compared with the normal population with VTE accounting for 3.6-11% deaths in CS patients. There are no specific guidelines for VTE prophylaxis in CS other than that it should be considered given the increasingly recognised risk.Methods: Via the Society for Endocrinology, we surveyed current VTE anticoagulation practice across UK Endocri...