Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology BES 2018

Glasgow, UK
19 Nov 2018 - 21 Nov 2018

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The Society for Endocrinology BES will take place 19-21 Nov 2018 in Glasgow. Come and exchange knowledge, share experiences and strengthen collaborations across our global community of endocrinologists.

ePoster Presentations

Neuroendocrinology and pituitary

ea0059ep71 | Neuroendocrinology and pituitary | SFEBES2018

Internal carotid artery haemorrhage in a patient with a radiotherapy treated pituitary macroadenoma with sphenoid extension and osteonecrosis

Butterly EW , Boyle R , Drummond R , Carty DM , Boyle JG , Currie G , Hughes KA

Pituitary macroadenomas often extend to the suprasellar region, however rarely they can extend inferiorly and include erosion into the sphenoid bone, presenting unique challenges. We present a 74-year-old female who received pituitary radiotherapy in 1995 for a pituitary macroadenoma with sphenoid extension. She initially presented in 1994 with secondary amenorrhoea and hyperprolactinaemia (30,000 mu/l). She could not tolerate MRI and subsequent CT showed a pituitary macroaden...

ea0059ep72 | Neuroendocrinology and pituitary | SFEBES2018

Carcinoid heart disease as the presentation of ovarian neuroendocrine tumour (NET) in the absence of liver metastases

Arambewela Maulee , Al-Mukhtar Ahmed , Macdonald Madeleine , Denis Andrew , O'toole Laurence , Munir Alia

Ovarian neuroendocrine tumours are rare (< 2% gynaecological tumours) and first described in 1939 by Stewart et al. The occurrence of carcinoid heart disease alongside this is anecdotal. We present a previously fit 66 year old female, with a 6 month history of shortness of breath and ankle oedema. Echocardiogram revealed severe fixed tricuspid regurgitation, pulmonary valve disease, dilated right heart chambers and preserved left ventricular function. Carcinoid heart disea...

ea0059ep73 | Neuroendocrinology and pituitary | SFEBES2018

Acute psychosis related pituitary haemorrhage

Ragbir Aneesa , Obuobie Kofi

Background: Pituitary haemorrhage or infarction into a pituitary tumour is well reported unlike isolated Pituitary haemorrhage due to traumatic injury of a normal gland.Case report: A previously healthy 44-year-old man presented following two episodes of seizures following a closed head injury. He reported transient extreme thirst, polyuria and headache at the outset, which had resolved by the time of admission. His Glasgow Coma scale was 14/15 and his c...

ea0059ep74 | Neuroendocrinology and pituitary | SFEBES2018

A rare case of prolactin secreting pituitary carcinoma with extra-cranial metastasis

Saeed Tamar , Halliday Jane , May Christine , Pal Aparna , Ansorge Olaf , Cudlip Simon , Jafar-Mohammadi Bahram

We present a case of 71-year-old gentleman who presented with bitemporal hemianopia in 2008 with pituitary apoplexy compressing the optic chiasm. Prolactin was 55287MU/l, with deficiency of all other anterior pituitary hormones. He underwent transphenoidal adenectomy (TSA). Prolactin was 35633MU/l post-operatively and cabergoline was commenced. Histology was consistent with a lactotroph adenoma with MiB-1 index of 3–5%. Visual fields recovered and prolactin was normal unt...

ea0059ep75 | Neuroendocrinology and pituitary | SFEBES2018

Unusual cause of meningioma

Nizar Hisham , Seal Leighton

Case: 60 year old transfemale had normal delivery, milestones and puberty. She developed gynaecomastia aged 14, associated obesity which resolved. As an adult she had reduced facial and body hair and reduced sexual function prior to hormone therapy but normal self-reported genitalia. She has female role from age of 24. She never had any children and was commenced female hormones 36 years ago. These were Premarin and Cyproterone Acetate which were continued post genital reconst...

ea0059ep76 | Neuroendocrinology and pituitary | SFEBES2018

Hyponatraemia associated with autoimmune limbic encephalitis

Ghosh Agrima , Kavuri Venkaiah , Sagi Satyanarayana V. , Oyibo Samson O.

Introduction: Limbic encephalitis is characterised by seizures, changes in personality and memory impairment. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) associated with autoimmune limbic encephalitis is rare. We present an interesting case.Case: A 57-year-old gentleman presented with seizures and a cardiac arrest. He had a past history of excess alcohol intake and had been taking excess alcohol prior to this event. Physical examinat...

ea0059ep77 | Neuroendocrinology and pituitary | SFEBES2018

Asynchronous delayed Growth Hormone co-secretion in a patient with a macroprolactinoma whilst on dopamine agonist therapy

Adil Maryam , Mathad Nijaguna , Richardson Tristan

We present a case of a 48 year old male who presented originally with a 8mm prolactinoma. He presented with a reduced libido for 6 months, and lethargy and retro-orbital headaches for the previous 18–24 months. He had no visual disturbance. Initial investigations revealed hyperprolactinaemia with a level of over 4000 iu/L and a normal IGF1 of 184 iu/L in the presence of a pituitary macroadenoma (8 x 11mm). He responded well to Cabergoline with a noticeable improvement in ...

ea0059ep78 | Neuroendocrinology and pituitary | SFEBES2018

Gigantism due to two different causes in the same family – AIP mutation-positive acromegaly and Marfan syndrome

Marques Pedro , Collier David , Barkan Ariel , Korbonits Marta

Germline aryl hydrocarbon receptor-interacting protein (AIP) mutations are responsible for 30% of pituitary gigantism cases. However, pathological accelerated growth and/or tall stature can be unrelated to the growth hormone (GH) axis, and may occur in isolation or as part of a syndrome, such as in Klinefelter, Marfan or Sotos syndromes. We report a five-generation kindred with two brothers with pituitary gigantism due to AIP mutation-positive GH-secreting pi...

ea0059ep79 | Neuroendocrinology and pituitary | SFEBES2018

Atypical presentation of Pituitary Apoplexy with fevers and gradual onset of headaches -Would you miss it?

Lunda Ngandu Danny , Subramaniam Yuvanaa , Rehmani Hassan , Stojanovic Nemanja , Hossain Belayat , Mlawa Gideon

Introduction: Pituitary apoplexy is both an endocrine and a neurosurgical emergency, and can typically present with sudden onset of headaches, impaired level of consciousness, fever, visual disturbances, nausea or vomiting. Apoplexy ensues when pre-existing pituitary tumour presumably outgrows its blood supply leading to ischaemia, necrosis and haemorrhage or infarction.Case: A 31-year-old man presented to the hospital with 3 months’ history of grad...

ea0059ep80 | Neuroendocrinology and pituitary | SFEBES2018

A difficult case of Cushing’s disease with unexplained hypertension and rapid metabolic decompensation

Sutton Smith Mark , Cox Jeremy , Robinson Stephen

A 26 year old man of Angolan descent presented to the endocrine clinic with poorly controlled hypertension (systolic blood pressure >200 mmHg). He had been treated with Amlodipine for almost six years, and more recently the addition of Irbesatan and Indapamide had not led to adequate blood pressure control. His hypertension was diagnosed at age 19 and progressive features of Cushing’s disease had remained unnoticed, with truncal striae, easy bruising, myopathy, puffin...

ea0059ep81 | Neuroendocrinology and pituitary | SFEBES2018

Secondary resistance to Cabergoline-pitfalls and challenges of managing macroprolactinoma with high dose dopamine agonist therapy

Abdalaziz Altayeb , Nag Satyajit , Dhakshinamoorthy Barkavi

Dopamine agonists (DA) are first line therapy for Prolactinoma which normalises prolactin(PRL) level in 80% of cases at a median weekly dose of 1 mg. An accepted criterion of pharmacological resistance to DA is failure to normalize PRL levels. We report a case of aggressive macroprolactinoma that required 7 mg of Cabergoline to reduce prolactin despite radiological evidence of tumour shrinkage. A 42 year old male presented with a bitemporal field defect. Imaging confirmed an i...

ea0059ep82 | Neuroendocrinology and pituitary | SFEBES2018

Acromegaly due to a mixed growth hormone secreting adenoma-gangliocytoma - a rare cause of GH excess

Wood Maximilian , Varma Anil , Scoones David , Nag Sath

Adeno-gangliocytomas are rare tumours of the pituitary gland with less than 40 cases described worldwide. Due to the rarity of these tumours, treatment modalities largely follow that of conventional therapies for common pituitary lesions. Case reports on these tumours offer insight into their presentation and the effectiveness of treatment which helps guide future management. A 64-year-old man was admitted for stone fragmentation and ureteric stent insertion. During anaestheti...

ea0059ep83 | Neuroendocrinology and pituitary | SFEBES2018

A disappearing act in the pituitary fossa with recovery from panhypopituitarism

Goodchild Emily , Evanson Jane , Drake William , Glynn Nigel

A 36-year-old, previously healthy, man presented with several weeks’ history of gradually worsening headache. He attended A&E after he was woken by sudden worsening of the headache, associated with vomiting and pre-syncopal symptoms. Investigations revealed severe hyponatraemia - serum Na 109 mmol/L. He was also severely hypocortisolaemic – serum cortisol (random) 16 nmol/L, ACTH 19 ng/L. Cranial imaging revealed a 17 mm suprasellar, complex cystic pituitary lesi...

ea0059ep84 | Neuroendocrinology and pituitary | SFEBES2018

A clinically functioning gonadotroph adenoma presenting with abdominal pain, bilateral multi-cystic ovaries and fibromatosis

Broughton Chloe , Sorour Mohammad , Mears Jane , Williams Adam , Lonnen Kathryn

Introduction: We present the case of a clinically functioning gonadotroph adenoma in a pre-menopausal woman with abdominal pain, bilateral multi-cystic ovaries and fibromatosis. To our knowledge, this is the first case of fibromatosis associated with a functioning gonadotroph adenoma.Case: A 36 year old female presented on three occasions with acute abdominal pain. She was previously well and had two normal pregnancies. On the first admission, she underw...

ea0059ep85 | Neuroendocrinology and pituitary | SFEBES2018

The many faces of hypoglycaemia–Would you recognise all of them?

Mlawa Gideon , Subramaniam Yuvanaa , Wilson Phillip , Bano Gul

Introduction: Hypoglycaemia is an endocrine and medical emergency. It is usually due to the excessive dose of insulin or oral anti-diabetic agents. Although rare, hypoglycaemia can be a tumour–induced. Some of the other causes include renal and liver failure, hormonal deficiency, antibodies to insulin, infection, starvation, spontaneous hypoglycaemia and reactive hypoglycaemia.Case report: A 70-year-old man presented with 6 months’ history of r...

ea0059ep86 | Neuroendocrinology and pituitary | SFEBES2018

Sheehan’s syndrome in a man

Almazrouei Raya , Meeran Karim

Background: The blood supply of the pituitary gland comes via a portal circulation from the hypothalamus. During pregnancy, the anterior pituitary gland enlarges but the blood supply cannot increase, as it is derived from a capillary plexus. The pituitary is thus vulnerable to arterial pressure changes and infarction secondary to hypotension. We describe a case of a male patient with large pituitary adenoma who developed Sheehan’s like syndrome due to adenoma infarction s...

ea0059ep87 | Neuroendocrinology and pituitary | SFEBES2018

Weight-related hypothalamic dysfunction: a memorable case

Osibogun Osiyosola O , Okwerekwu Francis C , Oyibo Samson O

Background: The effect of weight loss on hypothalamic function is complex and not fully understood. There is interplay between neuropeptides (leptin, ghrelin) and hypothalamus with the postulated aim of energy conservation and prevention of pregnancy during unfavourable conditions. We present a memorable case.Case: A 35-yr-old lady presented with secondary amenorrhoea of 17 years duration. She attained menarche at age 13. At age 16 her periods became sca...