Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology BES 2017

Harrogate, UK
06 Nov 2017 - 08 Nov 2017

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SfE BES 2017 will be on the 6-8 November 2016 in Harrogate, UK.

ePoster Presentations

Adrenal and Steroids

ea0050ep002 | Adrenal and Steroids | SFEBES2017

Transient adrenal insufficiency secondary to chronic opioid drug therapy

Vanderpant Natalie , Bravis Vassiliki

Introduction: Opioid drugs are used frequently for the management of moderate-to-severe chronic pain. Whilst their use is known to impact on endocrine function, this impact is not always well described. We present an unusual case of opioid-induced primary hypoadrenalism, which fully resolved on withdrawal of opioid medications.Case: A 54-year old female presented with a 13-month history of severe thoracic arthritic pain, for wh...

ea0050ep003 | Adrenal and Steroids | SFEBES2017

A challenging case of primary aldosteronism presenting in pregnancy

Ghela Anila , Kashif Muhammad , Akhtar Simeen , Howell Simon , Kaushal Kalpana

Primary aldosteronism (PA) uncommonly presents during pregnancy. Uncontrolled blood pressure may result in adverse maternal and fetal outcomes. We report a case presenting in pregnancy whose management proved particularly challenging, due to variable compliance with therapy, frequent non-attendance at clinic, a subsequent pregnancy and negative imaging.A 24 year old woman presented at 26 weeks gestation with severe pre-eclampsi...

ea0050ep004 | Adrenal and Steroids | SFEBES2017

An unusual case of acute adrenal insufficiency

James Lucas , Bellankannan Raj , Buch Harit

Adrenal insufficiency is an uncommon endocrine condition with an incidence of 4 cases per million. Common non-iatrogenic causes include autoimmunity, infections and infiltrations. We describe a case of acute adrenal insufficiency secondary to an unusual cause.A 77-year old female was admitted under the surgeons with abdominal pain and pyrexia. Abdominal ultrasonography showed large stones within a thickened gallbladder and a pr...

ea0050ep005 | Adrenal and Steroids | SFEBES2017

A rare occurence of adrenal leiomyosarcoma

Sharma Aditi , Lewington-Gower Elisa , Palazzo Fausto , Pokrajac Ana

Leiomyosarcoma is a rare, malignant tumour that can arise from smooth muscle cells anywhere in the body; common sites include uterus, GI tract and retroperitoneum. We report an unusual case of a patient with an adrenal incidentaloma confirmed as a leiomyosarcoma on histology.A 61-year-old Caucasian female was investigated for chronic abdominal pain. CT scan of the abdomen and pelvis did not show any pathology other than an inci...

ea0050ep006 | Adrenal and Steroids | SFEBES2017

Rare case of bilateral massive adrenal myelolipoma in association with congenital adrenal hyperplasia

Shahbuddin M. Ibrahim , Hughes David

Introduction Adrenal myelolipomas are rare small benign tumours composed of mature fat and hemopoietic tissues, which can be associated with congenital adrenal hyperplasia (CAH). We report a rare case of massive bilateral adrenal myelolipomas.Case report A 48 year old gentleman with CAH diagnosed during childhood presented at a routine endocrine appointment. He had not regularly attended his appointments or taken his steroids f...

ea0050ep007 | Adrenal and Steroids | SFEBES2017

Respiratory muscle weakness and diaphragmatic failure secondary to cushing’s syndrome

Gherman-Ciolac Carolina , Kandaswamy Leelavathy , Hatta Fara , Buch Harit

Respiratory muscle weakness and diaphragmatic failure is a rare presentation of hypercortisolism. We report a case of Cushing’s syndrome in a 60-year-old female with history of rheumatoid arthritis, biliary cirrhosis and hypothyroidism. She presented to the Respiratory Physicians with progressive worsening of shortness of breath. Clinical assessment excluded infective pathology, cardiac failure or asthma. Pulmonary function tests (PFT) showed re...

ea0050ep008 | Adrenal and Steroids | SFEBES2017

Glucocorticoid and mineralocorticoid Insufficency on treatment with tramadol

Anthony Wilton , Shaikh Mansoor , Searell Katrin

A 30 year old female presented with recurrent episodes of collapse with hypotension. She had been taking tramadol 100 mg four times daily for pain due to endometriosis. A random cortisol of 110 nmol/L led to suspicion of opiate induced adrenal insufficiency and further investigations were undertaken. Results 09:00 hours ACTH 3.2 ng/L, cortisol 109 nmol/L, fT4 12.3 pmol/L, fT3 3.7 pmol/L, TSH 1.18 mU/L, FSH 6.8 IU/L, LH 12.1 IU/L, prolactin 438 mU/L a...

ea0050ep009 | Adrenal and Steroids | SFEBES2017

Pitfalls in the management of indeterminate adrenal masses

Vogiatzi Evangelia , Konstantakou Panagiota , Tzemeli Xakousti , Sykiotis Antonis , Ntali Georgia

Introduction A few adrenal masses may elude characterization on cross-sectional imaging and remain indeterminate. These include lipid-poor adenomas, adrenal metastases and carcinomas and phaeochromocytomas. It is important to distinguish between them, as phaeochromocytomas can be fatal if operated without preoperative blockade. Their clinical spectrum varies, from dramatic symptoms and signs including paroxysmal headache, flushing, diaphoresis, hyper...

ea0050ep010 | Adrenal and Steroids | SFEBES2017

Idiopathic spontaneous adrenal haemorrhage in pregnancy

Talla Maria Rita , Ghaus Aisha , Freel Marie

A 24-year-old woman presented at 33 weeks gestation with severe left-sided abdominal pain and orthopnoea. Ventilation-perfusion scan demonstrated two segmental mismatched defects consistent with bilateral pulmonary embolism. Anticoagulation with enoxaparin was commenced. MRI abdomen, carried out in view of abdominal pain, revealed a 4.5 cm left adrenal mass containing a fluid level. Appearances were in keeping with acute left adrenal haemorrhage. Imp...

ea0050ep011 | Adrenal and Steroids | SFEBES2017

Isolated DHEAS elevation causing Hirsutism and Oligomenorrhea – A case report

Ahmad Ehtasham , Hafeez Kashif , Arshad Muhammad Fahad , Isuga Jimboy

Hirsutism is an endocrine condition affecting females with growth of unwanted, male-pattern hair secondary to excess androgen activity. The most common cause of hirsutism in females is PCOS (Polycystic ovarian syndrome). Other causes are fairly rare including adrenal and ovarian androgen producing tumours. In 3% of cases no cause of hirsutism is found and these are termed idiopathic1. We describe a unique case of a 22-year-old presenting w...

ea0050ep012 | Adrenal and Steroids | SFEBES2017

A rare cause of hypertension in pregnancy

Harborow Charlotte E , Waghorn Alison J , Davison Andrew S

A 23-year-old female with severe resistant hypertension was referred to our Hospital. Her BP on arrival was 240/140 mmHg and she was 13 weeks pregnant. Labetalol had been prescribed previously (200 mg,TDS), with little success in controlling her symptoms. The patient reported headaches, migraines and flushing for several years, especially after eating, and worse during pregnancy. The patient had pre-eclampsia in her first pregnancy.<p class="abst...

ea0050ep013 | Adrenal and Steroids | SFEBES2017

Puzzling adrenal masses in a patient with hypertension

Millar Kate , Sim Sing Yang , Chong JSW Li Voon

A 42 year old male was referred to the endocrine clinic with accelerated hypertension (190/110) and an elevated aldosterone renin ratio (59). CT adrenal scan revealed a 16 mm diameter mass in the posterior limb of the right adrenal gland which was confirmed to be hyperfunctioning through adrenal vein sampling. Laparoscopic adrenalectomy was performed and histology confirmed cortical adenoma of the right adrenal gland consistent with Conn’s syndr...

ea0050ep014 | Adrenal and Steroids | SFEBES2017

Delayed diagnosis of neurofibromatosis type 1 associated phaeochromocytoma and intussuscepting sigmoid adenocarcinoma

Tisdale Mie Mie , Burgess Neil , Stearns Adam , Lopez Berenice , Sadah Jaan , Myint Khin Swe

Background: Neurofibromatosis type 1 (NF1) related Phaeochromocytoma is a rare endocrine disorder and diagnosis is frequently delayed. NF1 is frequently associated with gastro-intestinal stromal tumour but also reported with adenocarcinoma (rare genetic MLH1 mutation). We presented a case where diagnosis of phaeochromocytoma was delayed 5 years after initial symptoms and only incidentally found on scanning at the time of his presentation with colonic...

ea0050ep015 | Adrenal and Steroids | SFEBES2017

A case series of metastatic adrenocortical carcinoma at a tertiary care hospital in UK

Iqbal Fizzah , Flanagan Daniel

Introduction: Adrenocortical carcinoma is a rare malignancy with an incidence of 1–2 per milion population. We present our experience of three patients with adrenal incidentalomas which were subsequently confirmed to be metastatic adrenocortical carcinoma.Discussion: Our first case presented at 56 years of age with abdominal pain in the background of recent type 2 diabetes and history of alcohol related pancreatitis. CT sh...

ea0050ep016 | Adrenal and Steroids | SFEBES2017

‘Connshing syndrome’ as a cause of hypertension: case report

Lefter Antonia , Căpăt´ană Cristina , Deciu Diana , Radian Şerban , Poiană Cătălina

Introduction: An association between primary hyperaldosteronism and autonomous cortisol secretion, tentatively termed ‘Connshing’ syndrome, is becoming increasingly recognized.Aim: To present a case of primary hyperaldosteronism associated with ACTH-independent subclinical Cushing’s.Methods: Clinical examination, biochemical testing and imaging studies.Results: A 49-y...

ea0050ep017 | Adrenal and Steroids | SFEBES2017

Abstract Withdrawn....

ea0050ep018 | Adrenal and Steroids | SFEBES2017

Iatrogenic cushings syndrome precipitated by fluticasone nasal drops in HIV infected patient

Avari Parizad , Duffy Carmel , Kapembwa Moses , Qureshi Asjid

A 43 year old Somali woman presented with increasing fatigue, difficulty getting out of her chair and 15 kg weight gain over a one month. Past medical history included paranoid psychosis, nasal congestion due to adenotonsillarhypertrophy, and human immunodeficiency virus (HIV). Her HIV infection was well controlled (viral load <50RNA copies/ml), with excellent immunological reconstitution (CD4 count >500 cells/mm3). Current medicat...

ea0050ep019 | Adrenal and Steroids | SFEBES2017

Two cidental lesions: a benign adrenal schwannoma and cerebral meningioma

Avari Parizad , Sharma Aditi , Galliford Thomas

We report a case of two incidental lesions, a benign adrenal schwannoma and cerebral meningioma. There are no cases in the literature to link de-novo adrenal schwannoma and meningioma in patients. This case highlights the importance of multidisciplinary working to ensure expedited management in such cases.A 76 year old gentleman presented to ED with a seizure and a community-acquired pneumonia. Past medical history included atr...

ea0050ep020 | Adrenal and Steroids | SFEBES2017

The challenge of gender re-assignment in a female pseudohaemaphrodite in a resource poor setting: a case report

Olopade Oluwarotimi , Adekemi Yusuf , Temilola Mosanya , Olalekan Adesokan , Oluwamuyiwa Oluwatoke , David Ajani

Background: One of the rarely documented endocrine disorders in African setting is pseudo-haemaphroditism. Female pseudo-haemaphroditism (virilized female) is characterized by the presence of 46XX karyotype, ovaries, normal mullerian duct structures, absent wolffian duct structures and virilised genitalia due to androgens in-utero. The commonest cause is Congenital Adrenal Hyperplasia.Aim: To highlight the challenge in investig...

ea0050ep021 | Adrenal and Steroids | SFEBES2017

Shortcomings of the short Synacthen test; a near miss case of Addison’s disease

Sharma Aditi , Avari Parizad , Muralidhara Koteshwara

We present a case of a middle-aged lady with clinical features suspicious of Addisons, however an initial false negative short synacthen test (SST), resulted in delay of diagnosis.Case: A 62-year-old lady presented to ED with a month history of generalised malaise, weakness, dizziness and vomiting. She had a background of type2 diabetes mellitus, previous left parathyroidectomy for primary hyperparathyroidism and B-thalassaemia trait. Admission bloods in...

ea0050ep022 | Adrenal and Steroids | SFEBES2017

When One Diagnosis Reveals Another...

Heggie Alison , Nichols Matthew , Simkiss Lauri , Smith Jim , Nayar Rahul , Joshi Ashwin

A 37 year-old gentleman presented following an episode of dizziness while at work operating a fork-lift truck. There was no collapse or associated symptoms. He had been diagnosed with autoimmune hypothyroidism two months previously; commenced levothyroxine, currently at a dose of 75 micrograms daily; and lost ten kilograms in weight. On examination there were no signs of hypoadrenalism aside from a significant postural drop in blood pressure (lying 1...