Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology BES 2021

Edinburgh, United Kingdom
08 Nov 2021 - 10 Nov 2021

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Join us in Edinburgh for the flagship event of the Society for Endocrinology

Poster Presentations

Neuroendocrinology and Pituitary

ea0077p78 | Neuroendocrinology and Pituitary | SFEBES2021

The role of FGF signaling pathway in the pituitary stem cell compartment

Abascal Sherwell Sanchez Carlos M. , Lodge Emily , Willis Thea L. , Hajihosseini Mohammad K. , Andoniadou Cynthia L.

The FGF signalling pathway regulates cell proliferation, differentiation, migration and cell specification in mutliple developing and adult tissues. It has also been implicated in tumor development and progression with a significant role in the cancer pathobiology of several malignant tumors including melanoma, breast, pancreas, head and neck and non-small lung cell cancer. FGF signalling plays a major role in the postnatal hypothalamic-pituitary (HP) axis, with dysregulation ...

ea0077p79 | Neuroendocrinology and Pituitary | SFEBES2021

MRI bone shape in patients with acromegaly: a novel technique for the characterisation of the acromegalic arthropathy

Kyriakakis Nikolaos , Bowes Michael , Lynch Julie , Kingsbury Sarah , Orme Steve , Murray Robert , Conaghan Philip

Objective: Arthropathy is the commonest morbidity in acromegaly and the main determinant of quality of life in these patients. Most of current knowledge is derived from studies using conventional x-rays. This study aims to characterise acromegalic arthropathy using modern imaging techniques.Methods: Case control study comprising of 60 acromegaly patients (29 males, mean age 54.8± 12.9yrs) and 300 age/gender-matched controls from the publicly availab...

ea0077p80 | Neuroendocrinology and Pituitary | SFEBES2021

ACROBAT Advance: progress report on a study of long-term safety and efficacy of paltusotine for the treatment of acromegaly

Randeva Harpal , R . Gadelha Monica , Gordon Murray B. , Mezosi Emese , Doknic Mirjana , Toth Miklos , Boguszewski Cesar , Jochelson Theresa , Nichols Melissa , Luo Rosa , Madan Ajay , Ferrara-Cook Christine , Krasner Alan , Casagrande Alessandra , Scott Struthers R.

Paltusotine is a once-daily, oral selective nonpeptide somatostatin receptor type 2 (SST2) agonist, which is in clinical development for the treatment of acromegaly. Maintenance of insulin-like growth factor 1 (IGF-1) control and toleration was demonstrated in phase 2 studies evaluating paltusotine in biochemically controlled (IGF-1 ≤1xULN) [ACROBAT Evolve (NCT03792555)] and uncontrolled (1> IGF-1 ≤2.5xULN) [ACROBAT Edge (NCT03789656)] patients with acromegaly ...

ea0077p81 | Neuroendocrinology and Pituitary | SFEBES2021

Is gigantism different from acromegaly in terms of causes of death, comorbidities and treatment? A preliminary retrospective study of 156 UK giants

Kaniuka-Jakubowska Sonia , Abeyaratne Dayakshi , Pal Aparna , Plummer Zoe , Archer Natasha , Ayuk John , Kaszubowski Mariusz , Wass John , Korbonits Marta

Introduction: Although acromegaly and pituitary gigantism have the same pathological cause, they have different disease characteristics.Aim: To study tumour size, treatment course and the most common comorbidities in a population with young-onset acromegaly.Materials and Methods: UK Acromegaly Register (UKAR, 22 centres, 1997-2017) retrospective analysis, enriched with patients from the FIPA-consortium. We defined gigantism as diag...

ea0077p82 | Neuroendocrinology and Pituitary | SFEBES2021

Pituitary and gonadal axes in patients with ‘Long COVID’: post hoc analysis

Clarke Sophie , Phylactou Maria , Patel Bijal , Mills Edouard , Muzi Beatrice , Izzi-Engbeaya Chioma , Choudhury Sirazum , Khoo Bernard , Meeran Karim , Comninos Alexander , Abbara Ali , Tan Tricia , Dhillo Waljit

Background: It is apparent that COVID-19 may cause persistent symptoms beyond 12 weeks (‘long COVID’). However its underlying pathophysiology is unclear. Several symptoms of long COVID draw similarities to that of endocrine diagnoses. We recently observed that adrenal and thyroid function were normal in survivors of COVID-19 at follow-up. Here we assess additional endocrine axes that could plausibly have a role in long COVID to determine their relationship to ongoing...

ea0077p83 | Neuroendocrinology and Pituitary | SFEBES2021

Screening for diabetes insipidus with copeptin after overnight water deprivation

Larsen Niels , Sathyanarayanan Abilash , Fensom Benjamin , Hughes David

Introduction: Water deprivation testing (WDT) is considered the gold standard test in differentiating between craniogenic diabetes insipidus (DI), nephrogenic DI and primary polydipsia. However, it requires day case admission for monitoring of sodium and osmolality. Copeptin, derived from pre-provasopressin, is secreted in an equimolar amount with arginine vasopressin and has a potential role in facilitating the diagnosis of DI and reducing the need for WDT. Copeptin was gradu...

ea0077p84 | Neuroendocrinology and Pituitary | SFEBES2021

Cinnamomum zeylanicum bark extract showed ameliorative properties against streptozotocin-induced insulin resistance in the hippocampus of experimental wistar rat

Olanrewaju John , Adesina Oluwamayomiposi

Insulin resistance is one of the metabolic pathogenesis of Type 2 diabetes mellitus which cause neurodegeneration, due to its effects on insulin signaling pathway. The present study focused on the intracerebroventricular administration of streptozotocin (STZ) to induce insulin resistance directly in brain, accounting for alteration in insulin signaling pathway and thus the possible therapeutic effect of Cinnamomum Zeylanicum on the impairment hippocampus of diabetic r...

ea0077p85 | Neuroendocrinology and Pituitary | SFEBES2021

Clinical presentation of 209 surgically operated non-functioning pituitary macroadenomas

Edwards Mared , Hayhurst Caroline , Mohamed Amr , Davies J Steve , Rees D Aled , Lansdown Andrew

Background: The clinical presentation of non-functioning pituitary adenomas (NFAs) can range from an incidental finding on imaging to pituitary hormone deficiencies and visual compromise.Objective: To assess the clinical presentation of patients who had undergone surgical resection of histologically proven NFAs.Methods: Patients presenting to the University Hospital of Wales, Cardiff, with non-functioning pituitary adenomas (histol...

ea0077p86 | Neuroendocrinology and Pituitary | SFEBES2021

A rare case of sellar pathology: Coinciding IgG4-related hypophysitis and pituitary adenoma

Hakami Osamah , Fountas Athanasios , Chavda Swarupsinh , Tsermoulas George , Ayuk John , Batra Ruchika , Karavitaki Niki

A 69-year-old man was referred to our Pituitary Service for a 3-month history of progressive right visual loss and a finding of “pituitary enlargement” on brain MRI. He reported erectile dysfunction and his medical history included asthma, DM2 and meningitis (8 years ago). Neuro-ophthalmology review showed visual acuity 6/60, optic neuropathy, marked visual field loss with residual superonasal island in right eye, mild 6th nerve palsy. Pituitary MRI: infil...

ea0077p87 | Neuroendocrinology and Pituitary | SFEBES2021

Persistent gestational diabetes insipidus

Maharajh Anjanie , Kyaw Tun Julie

We report a 33 year old female who presented at 23 weeks gestation with rapid onset polyuria and polydipsia. Fluid input and output was approximately 12 litres per day. She denied any other symptoms. She did not have signs of hypopituitarism, Acromegaly or Cushing’s syndrome. Visual fields were normal to confrontation. Her standard glucose tolerance test, Hba1c, creatinine and calcium were normal. Gestational Diabetes Insipidus was (GDI) suspected. Given her pregnancy, a ...

ea0077p88 | Neuroendocrinology and Pituitary | SFEBES2021

Effects of ethanol extract of allium sativum L. On the hippocampus of male wistar rats with streptozotocin-induced brain insulin resistance

Taiwo-Ola Dorcas , Olanrewaju John , Bejide Ronald , Njideaka Temi

The hippocampus is majorly involved in memory formation. The insulin pathway regulates the level of GSK-3β, which is involved in the formation of amyloid beta and Tau. Allium sativumhas been shown to reduce amyloidogenesis and increase brain insulin sensitivity. 32 male Wistar rats were used in this experiment. They were grouped into 4, each with 8 rats. Group A (Sham), B (3 mg/kg of streptozotocin), group C (3 mg/kg of streptozotocin +300 mg/kg of Allium sat...

ea0077p89 | Neuroendocrinology and Pituitary | SFEBES2021

New presentation of asymptomatic acromegaly in patients with macroprolactinomas

de Bray Anne , Rahim Asad , Juszczak Agata

Background: Current guidance for the management of macroprolactinomas recommends full pituitary profile at baseline and subsequently only if symptomatic. Pituitary adenomas that co-secrete growth hormone and prolactin at presentation are well-recognised. Case reports of acromegaly after prolactinoma treatment are associated with symptomatic acromegaly. We present two patients with asymptomatic acromegaly years after diagnosis of macroprolactinoma.Patient...

ea0077p90 | Neuroendocrinology and Pituitary | SFEBES2021

Hypo and hypernatraemia on admission are associated with increased length of stay in unselected acute hospital admissions

Ellis Hugh Logan , Sharpe Claire , Kelly Phil , Al-Agil Mohammad , Teo James , Aylwin Simon , Whyte Martin

Introduction: Hyponatraemia is a common biochemical abnormality, complicating up to 15% of all hospital admissions and associated with increased mortality. Hypernatraemia, occuring less frequently, is strongly associated with mortality and is almost always due to a free water deficit. There is limited data about hospital healthcare burden of these two relatively common electrolyte imbalances. We analysed the length of stay, for acute admissions, with reference to the admission...

ea0077p91 | Neuroendocrinology and Pituitary | SFEBES2021

Rathke’s cleft cyst with a very unusual course

Coulden Amy , Pepper Joshua , Juszczak Agata , Batra Ruchika , Chavda Swarupsinh , Senthil Latha , Ayuk John , Pohl Ute , Nagaraju Santhos , Karavitaki Niki , Tsermoulas Georgios

A 31-year-old man without previous medical history presented to his local hospital with one week history of generalised severe headache. Brain CT was reported as negative for acute intracranial pathology. Five weeks later, he re-presented with worsening headache and blurring of vision. Brain CT revealed a large area of hypodensity centred on the left thalamus/basal ganglia and subsequent MRI with contrast showed a medium size pituitary cyst with suprasellar extension and two c...

ea0077p92 | Neuroendocrinology and Pituitary | SFEBES2021

Age- gender- and tanner stage-specific reference intervals for serum insulin-like growth factor binding protein 3 (IGFBP-3) and the insulin-like growth factor I (IGF-I) to IGFBP-3 molar ratios in healthy school children of a north indian city

Ravi Teja KV , Marwaha RK , Malhotra Bhanu , Sachdeva Naresh , Das Liza , Rastogi Ashu , Mukherjee Soham , Sharma Sadhna , Verma Neelam , Malhotra Sunita , Bhansali Anil , Bhadada Sanjay , Pal Rimesh , G Dewan , Monaghan Phillip , Trainer Peter , Korbonits Marta , Dutta Pinaki

Context: Serum IGF-binding protein-3 (IGFBP-3) and molar IGF-I to IGFBP-3 ratio can aid the diagnosis of GH-related diseases. However, their clinical utility is limited by lack of validated reference intervals.Objectives: To establish age-, gender- and Tanner stage-specific reference intervals for IGFBP-3 and IGF-I to IGFBP-3 ratio for Indian ethnicity.Setting and Participants: We conducted a cross-sectional epidemiological study (...

ea0077p93 | Neuroendocrinology and Pituitary | SFEBES2021

Healthcare professionals’ survey on the inpatient safety of Diabetes Insipidus

Ladher Ramesh Kumar , Ramesh Rommel , Shah Kausar , Mullard Katie , Rao Ranganatha

Background: Knowledge of glucocorticoid use during acute illness is widely known, however, knowledge of Diabetes Insipidus (DI) is suboptimal amongst healthcare professionals. In 2009, a series of medical and management failures led to the death of 22 year old from DI in a London hospital. Since then increased efforts have been made to raise awareness about the inpatient management of DI and dangers associated with delay and/or omission of desmopressin. An NHS England patient ...

ea0077p94 | Neuroendocrinology and Pituitary | SFEBES2021

A case of pituitary abscess – a rare clinical entity

El-Abd Souha , Knysak Alicja , Chilton Angharad , Al-Mrayat Ma’en , Hempenstall Jonathan

Background: Pituitary abscess is a rare entity which is often not suspected in pituitary lesions differential diagnoses; arising de novo or as a consequence of sinus infection, meningitis, or haematogenous spread. The diagnosis is challenging and mostly made during surgery.Case Report: A 54-year-old male patient presented with 3 days of severe headaches, vomiting, and left eyelid drooping. He was afebrile, BP 90/61mmHg, and had a left third nerve palsy w...

ea0077p95 | Neuroendocrinology and Pituitary | SFEBES2021

Coronary artery bypass grafting (CABG)-related pituitary apoplexy

Serban Laura , MacFarlane James , Senanayake Russell , Stastna Daniela , Mathew Rajeev , Sharma Rishi , Mannion Richard , Gurnell Mark , Bashari Waiel

Background: Pituitary apoplexy is a relatively rare but important clinical syndrome which may be associated with acute headache, visual compromise and hypopituitarism. It can be the initial presentation of a previously unsuspected pituitary macroadenoma. Recognised risk factors include hypertension and the use of antiplatelet agents and/or anticoagulant therapy. It may be life-threatening, requiring emergency endocrine (e.g hydrocortisone) replacement therapy[1] and...

ea0077p96 | Neuroendocrinology and Pituitary | SFEBES2021

Primary empty sella syndrome (PESS) audit in a southwest tertiary hospital

Biaye Abraham , Ball Georginal , Patel Nishchil , Dimitropoulos Ioannis , Flanagan Daniel

Empty sella is an incidental finding characterised by the herniation of subarachnoid space into the sella turcica with resultant flattening of pituitary gland to varying extent. It was considered benign. But recent reviews have shown its association with some neuroendocrinopathies.Aims and Objectives: To determine if patients with radiological diagnosis of PESS were;1. Referred to Endocrinology team?2. What p...

ea0077p97 | Neuroendocrinology and Pituitary | SFEBES2021

Management of Complicated Pit-1 staining Non-functioning Pituitary macroadenoma in Pregnancy

Machenahalli Pratibha , Thandani Puja , Shad Amjad , Sherlala Khalid , Giovos Georgios , Dhingra Vandana , Randeva Harpal

Background: Incidence of non-functioning pituitary macroadenoma (NFPMA) is very rare in pregnancy. We describe a case of complicated non-functioning pituitary macroadenoma presented during pregnancy. 26 year old female at 21 weeks gestation presented to emergency services with worsening headaches, nausea and vomiting for 2-3 months. This was associated with transient double vision and confusion since 2 days. She was admitted to emergency department 3 weeks ago with vomiting an...

ea0077p98 | Neuroendocrinology and Pituitary | SFEBES2021

Hypopituitarism secondary to hydrocephalus associated with tectal plate tumour

Lakshmipathy Kavitha , Smout Vera , Emmanuel Julian , Nayyar Vidhu , Field Benjamin , Clark James , Zachariah Sunil

Case History: 17 year old boy presented with a six week history of polyuria, polydipsia, headaches and easy fatiguability. Further investigations confirmed hypopituitarism with low early morning urine osmolality. MRI brain revealed soft tissue mass arising from tectal plate extending into cerebral aqueduct resulting in hydrocephalus with normal pituitary gland. Hydrocortisone, Levothyroxine and Desmopressin were started and urgent in-patient transfer to Neurosurgical unit in t...

ea0077p99 | Neuroendocrinology and Pituitary | SFEBES2021

Retrospective audit of clinical, biochemical and radiological features of Pituitary apoplexy

Machenahalli Pratibha , Shad Amjad , Shrelala Khalid , Thandani Puja , Giovos Georgios , Khan Uzma , Page Tristan , Haris Faiza , Smith Megan , Randeva Harpal

Background: Pituitary apoplexy is one of the rare endocrine emergencies. Most series indicate that incidence is between 2-7% based on clinical, surgical and histopathological evidence.1-3 Usually presents with severe headaches that may be associated with nausea vomiting, ocular palsies, fever, photophobia. Predisposing factors are pre-existing pituitary conditions, hypertension, major surgery, anticoagulation therapy, pregnancy, radiotherapy. Appropriate endocrine, ...

ea0077p100 | Neuroendocrinology and Pituitary | SFEBES2021

Conservative management of Cushing’s in COVID times: A case series and meta-analysis

Sharma Bhavna , Rahman Mushtaqar

We present a case series of patients admitted to our hospital with various manifestations of Cushing’s. 71 male, known type 2 diabetes, hypertension referred for adrenal incidentaloma. Cushingoid features with non suppressed ACTH. Low dose dexamethasone test (LDSST): no suppression. 4 cm pituitary microadenoma (likely co-secretory as gonadotropins elevated). Offered IPSS and pituitary surgery. Declined the same due to fears of COVID opted for medical therapy with metyrapo...

ea0077p101 | Neuroendocrinology and Pituitary | SFEBES2021

Worst headache of my life

Kejem Helmine , Mahmud Ahmad , Yusuf Mohamoud

Introduction: Pituitary apoplexy is a rare clinical syndrome secondary to abrupt haemorrhage or infarction of the pituitary gland. It complicates 2-12% of pituitary tumour, most commonly in the setting of non-functioning adenomas 1. We are reporting a case on the evolving apoplexy. A 28-year-old male with sudden onset stabbing type frontal headache at night. He described this as the worst headache in his life. CT scan of head at presentation showed a 1.9 m lesion in the pituit...

ea0077p210 | Neuroendocrinology and Pituitary | SFEBES2021

Management of cranial Diabetes Insipidus in a tertiary centre – clinical outcomes and patient perception of care

Dilrukshi MDSA , Vickars Marcus , May Christine , Makaya Taffy , Ryan Fiona , Mohammadi Bahram Jafar , Wass John , Pal Aparna , Garrahy Aoife

There is growing recognition within Endocrinology physician and patient groups of morbidity and mortality in association with prescribing errors and dysnatraemia, in hospitalised patients with cranial diabetes insipidus (CDI). The aims of this study were firstly, to assess outcomes in hospitalised patients with CDI by review of electronic records from 2012-2021, and secondly, to assess the same patient cohort’s perceptions of their care via telephone questionnaire. 109 pa...

ea0077p211 | Neuroendocrinology and Pituitary | SFEBES2021

Digital transformation of a hyponatraemia toolkit: impact on clinical practice

Zeeshan Amna , Devendra Senan , O’Dowd Christina , Shah Pooja , Goodka Roshni , Devendra Ruben , Obaidee Sayed , Patel Bharat

Hyponatraemia is associated with an increased morbidity and mortality. Despite having a hyponatraemia algorithm (pdf format) on our hospital intranet, it was rarely accessed and a wide variation in care was noticed. A novel digital hyponatraemia diagnostic toolkit ( for Foundation doctors (FDs) was introduced to assess our aims if it: A) increases the awareness of FDs to start investigating when serum Sodium is <130 mmol/l B) increases FD...

ea0077p212 | Neuroendocrinology and Pituitary | SFEBES2021

Cabergoline treatment in human primary non-functioning pituitary adenomas

Begalli Federica , Komagata Tatsuya , Suleyman Oniz , Magid Kesson , Rice Thomas , Collier David , Dorward Neil , Grieve Joan , Mendoza Nigel , Nair Ramesh , Kolias Angelos , Khan Danyal , Marcus Hani J , Botta Joaquin , McCormick Peter J , Shinozaki Koji , Korbonits Marta

Non-functioning pituitary adenomas (NFPAs) are the second most common subtype (15-43%) of all clinically presenting pituitary adenomas. Although the primary treatment of symptomatic NFPAs is surgery, gross total resection is achieved only in about 66% of the cases, and 20% of gross total resected tumours recur after 10 years. Despite recent advances in medical management of pituitary tumours, NFPAs remain the only subtype with no widely accepted pharmacological treatment. Expr...

ea0077p213 | Neuroendocrinology and Pituitary | SFEBES2021

The use of low dose tolvaptan for the treatment for hyponatraemia - a retrospective analysis of its efficacy and safety

Llewellyn David , Aylwin Simon

Aims: The lowest licensed dose of tolvaptan for treatment of hyponatraemia is 15 mg. There is little data on lower doses. Our study aimed to evaluate the safety of an initial dose of 7.5 mg tolvaptan.Methods: We retrospectively reviewed data from a London teaching hospital over a 6-year period. All adults administered a first dose of 7.5 mg tolvaptan were included. Three different timeframes were reviewed: 4-12, 12-18 and 18-30 hours. We analysed respons...

ea0077p214 | Neuroendocrinology and Pituitary | SFEBES2021

Pregnancy and neuroendocrine neoplasms

Ratnayake Gowri M , Armonis Panagiotis , Hayes Aimee R , Mandair Dalvinder , Khoo Bernard , Toumpanakis Christos , Grossman Ashley B , Caplin Martyn E

Background: The incidence of neuroendocrine neoplasms (NENs) in younger populations (<50 years) is increasing and was 1.8 per 100,000 persons in 2011. There is limited data on NENs and pregnancy.Methods: A retrospective analysis was performed on pregnant women with NENs managed in an ENETS Centre of Excellence. The objectives of the study were to describe the tumour characteristics, pregnancy outcomes, treatment and the tumour behaviour intra-pregnan...

ea0077p215 | Neuroendocrinology and Pituitary | SFEBES2021

Prevalence of cholelithiasis in somatostatin analogues treated Acromegaly patients

Sim Sing , Mavilakandy Akash , Bremner Emma , Barrowcliffe Mary , Bhake Ragini , Robertson Iain , Levy Miles , Reddy Narendra

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...

ea0077p216 | Neuroendocrinology and Pituitary | SFEBES2021

Neuroendocrine Tumours (NETS): Telemedicine and patient satisfaction in the COVID-19 pandemic: A patient survey from a European Neuroendocrine Tumour Centre of Excellence

Seneviratne Dilini , Paramore Jane , Bates Suzanne , Ibbotson Victoria , Dunkley Kay , Munir Alia

Introduction: NETs are regarded as rare endocrine malignancies, which often present late. The COVID-19 pandemic may have affected this and patient care. The impact will have been felt in health service delivery and patient experiences. To understand NET patient perspectives and optimise care, we conducted a survey to review patient perception of: telemedicine-based care, delays to imaging, treatment, and the impact of COVID-19.Method: 70 NET patients tre...

ea0077p217 | Neuroendocrinology and Pituitary | SFEBES2021

Comparison of cardiovascular outcomes of radiotherapy vs non-radiotherapy cohort of Acromegaly patients

Mavilakandy Akash , Bhake Ragini C , Bremner Emma , Barrowcliffe Mary , Robertson Iain , Levy Miles J , Reddy Narendra L

Background: Radiotherapy is a third line treatment in Acromegaly. Pituitary radiotherapy (RT) is known to have cardiovascular complications (MI/IHD, CCF & CVA) due to radiation effects on normal pituitary and surrounding structures over and above the excess Growth hormone risk on metabolism (1).Objective: To compare RT vs non-RT treated Acromegaly cohorts’ cardiovascular (CV) outcomes in unselected consecutive Acromegaly patients.<p class="a...

ea0077p218 | Neuroendocrinology and Pituitary | SFEBES2021

Imaging screening for lung cancer required at diagnosis and at 6 months after established diagnosis of SIADH? A retrospective Audit of real-life clinical practice

Ahmad Waqar , Ahmed Sajeel , Panagiotou Grigorios , Pearce Simon

Background: Syndrome of Inappropriate Anti-diuretic Hormone (SIADH) secretion is the most common cause of hyponatremia in cancer patients. About 14% of hyponatremia in medical inpatients is due to underlying tumor-related conditions. We performed an audit to evaluate prevalence of lung malignancy in patients newly diagnosed with SIADH and to assess proportion of patients having radiological evidence of lung cancer through chest x ray and/or CT chest imaging six months after es...

ea0077p219 | Neuroendocrinology and Pituitary | SFEBES2021

Pituitary apoplexy- a retrospective analysis of clinical features, management and outcomes

Ghenoiu Sandra , Ciubotaru Gheorghe Vasile , Dumitraucu Anda , Căpăt.ină Cristina , Poiană Cătălina

Introduction: The term “pituitary apoplexy” (PA) describes the appearance of abrupt hemorrhage and/or ischaemia of the constituents of sella turcica, usually in a pre-existing pituitary tumor. The presentation of this syndrome may be acute or subclinical.Objective: This study aims to assess clinical, imaging and hormonal features and the outcomes following surgery or conservative treatment among pituitary adenoma patients presenting with PA.</p...

ea0077p220 | Neuroendocrinology and Pituitary | SFEBES2021

Multiple Cell Line Pituitary Adenoma associated with PIT-1 and TPIT lineage cells resulting in acromegaly with ACTH dependent Cushing’s: a case report

Joshi Hareesh , Ye Kyaw , Bridges Leslie , Martin Andrew , Bano Gul

Introduction: Anterior pituitary cells are characterised by functional lineages based on the expression pattern of transcription factors. Functional differentiation in the form of pituitary adenomas co-secreting ACTH and growth hormone is very rare. We report a case of multiple cell line pituitary adenoma resulting in acromegaly and ACTH dependent Cushing’s.Case: A 52-year-old woman of Ghanian origin (BMI of 57.5 kg/m2) presented with pro...

ea0077p221 | Neuroendocrinology and Pituitary | SFEBES2021

The usefulness of measuring neurone specific enolase in patients seen in the Endocrine Clinic

Gohil Shailesh , Jumaah Ali Al , Rahman Faizanur , Reddy Narendra , Bhake Ragini , Levy Miles

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...

ea0077p222 | Neuroendocrinology and Pituitary | SFEBES2021

SDHD missense pathogenic variants: not always benign

Haboosh Sara , Carroll Paul , Izatt Louise , Quinn Mark , Velusamy Anand

Pathogenic variants in the SDHx genes are responsible for ~20% of familial Phaeochromocytoma/Paraganglioma (PPGL) tumours. Metastatic disease is lower in SDHD in comparison to SDHA, B and C mutations. Although the genotype-phenotype relationship is not well established it is considered that truncating SDHD pathogenic variants have a higher risk of causing disease in comparison to missense variants. We present two cases of metastatic paraganglioma in patients with heterozygous ...

ea0077p223 | Neuroendocrinology and Pituitary | SFEBES2021

Generation of normative data on serum insulin-like growth factor I (IGF-I) in healthy school children of a north indian city

Dutta Pinaki , Teja KV Ravi , Aggarwal Arun , Sachdeva Naresh , Malhotra Bhanu , Das Liza , Walia Rama , Rastogi Ashu , Bhansali Anil , Bhadada Sanjay , Pal Rimesh , G Dewan , Marwaha R K , Monaghan Phillip , Trainer Peter , Korbonits Marta

Context: To diagnose and monitor GH-related disorders, serum IGF-I is a cornerstone, but Indian ethnicity based data, following consensus criteria for establishment of normative data are not available.Objectives: To generate normative IGF-I data for chronological age, bone age (BA) [Greulich & Pyle] and Tanner stage for both genders.Setting and Participants: We conducted a cross-sectional epidemiological study for children (age...

ea0077p224 | Neuroendocrinology and Pituitary | SFEBES2021

Three cases of metastatic spinal cord compression secondary to malignant pheochromocytoma and paraganglioma

Khan Amber , Kapoor Ashutosh , Manoharan Prakash , Chander Amarjot , Westwood Thomas , Woolf David , Hoong Ho Jan , Adam Safwaan

Approximately 15-20% of phaeochromocytomas and paragangliomas (PPGL) are metastatic. Metastatic spinal cord compression (MSCC) has been reported infrequently. We present three cases of MSCC secondary to metastatic PPGLs. MSCC can occur in patients with PPGLs and should be considered in patients with either spinal symptoms or spinal metastases on imaging. Our series has shown radiotherapy followed by therapeutic MIBG to be effective in treating spinal metastases. Each case shou...

ea0077p225 | Neuroendocrinology and Pituitary | SFEBES2021

Utility of prolactin measurement in inferior petrosal sinus samples when investigating ACTH dependent cushing’s

Hashim Ibrahim , Mickey Bruce

Introduction: The use of Inferior Petrosal Sinus Sampling (IPSS) to differentiate between central and ectopic ACTH dependent Cushing’s, although requires expertise, is widely available. The value of adding prolactin measurement to that of ACTH to improve IPSS diagnostic accuracy remains controversial. We evaluated the impact of adding prolactin measurement to IPSS procedures at a large academic center.Methods: Leftover samples from patients who were...

ea0077p226 | Neuroendocrinology and Pituitary | SFEBES2021

Complete third nerve oculomotor nerve palsy as initial presentation of pituitary tuberculosis

Alameri Majid , Alnuaimi Abdulla , Rawson Timothy , Sanderson Frances , Wernig Florian

Introduction: Pituitary tuberculosis (TB) is a rare form of intracranial TB and remains a diagnostic challenge in the absence of systemic TB. A limited number of cases has been reported in the literature.Case: A 47-year-old south Asian man presented to the accident and emergency department with complete isolated left third nerve palsy which had developed gradually over the course of a week. Brain magnetic resonance imagining (MRI) revealed a 15 mm inflam...

ea0077p227 | Neuroendocrinology and Pituitary | SFEBES2021

Ectopic Cushing’s syndrome: challenging the stereotype

Wordsworth Georgina , Talbot Fleur , Cheyne Elizabeth , Chau Fong , Lonnen Kathryn , Tatovic Danijela , Russell Georgina , Kahal Hassan , Parfitt Vernon

Ectopic Cushing’s syndrome (CS) is commonly caused by malignancy, often behaves aggressively and may not clinically manifest with features of hypercortisolism due to its rapid course and associated cachexia. This may mislead clinicians into discounting the diagnosis in patients with more indolent features of CS. We present a 41 year old woman with an 8 year history of Cushingoid features with associated hypertension, obesity and Type 2 Diabetes. Investigations confirmed C...

ea0077p228 | Neuroendocrinology and Pituitary | SFEBES2021

Rhabdomyosarcoma in Carney complex - Is there an association

Yang Sim Sing , Al-Mrayat Ma’en

Carney complex is a rare autosomal dominant syndrome characterized by multiple pigmented lesions on the mucosae and skin, cardiac myxoma, endocrine and non-endocrine tumours. It is caused by mutations of the PRKAR1A gene on chromosome 17q. We present a 24-year-old gentleman with Carney’s complex PRKAR1A gene positive. He has a strong family history of Carney complex- He also has a sister and 3 half- brothers who were also affected. One of his half-brothers has primary adr...

ea0077p229 | Neuroendocrinology and Pituitary | SFEBES2021

Case report: pituitary metastasis and Its diagnostic complexity

Chaudhury Nadia , Thadani Puja , Awala Orighomisan , Randeva Harpal , Correa Peter , Machenahalli Pratibha , Gholap Nitin

Background: Pituitary metastasis (PM) is a rare occurrence in malignancy, associated with poor prognosis. Only 7% of patients are symptomatic. High index of suspicion and prompt investigation are essential. We report a case of PM, highlighting challenges in diagnosis and management.Case Report: Sixty-six year old male was referred to endocrinology due to headaches and hyponatremia. He had metastatic colorectal carcinoma, treated with bowel, liver and lun...

ea0077p230 | Neuroendocrinology and Pituitary | SFEBES2021

Immune check point inhibitor induced hypophysitis with normal pituitary imaging

Ali Tauni Rahat , Ali Khan Amjad , Kehinde Razak

We present a 60-year-old man who was referred to endocrine clinic with fatigue and a random cortisol of 136nmol/l . He had clear renal cell carcinoma and had right radical nephrectomy 7 years ago. Surveillance scans revealed involvement of mediastinal lymph nodes, pancreas and small bowel and he has pancreatic and small bowel resection in four years ago. He had recurrence a year ago and received Ipilimumab and Nivolumab. Biochemistry revealed low fT4 and inappropriately normal...

ea0077p231 | Neuroendocrinology and Pituitary | SFEBES2021

A challenging adrenal incidentaloma

Mantega Michele , Ronneberger Ruth , Baldeweg Stephanie , Grieve Joan , Seechurn Shivshankar , Qureshi Asjid

Case History: 69 years old gentleman was referred to endocrinology for investigation of a benign appearing left incidental adrenal adenoma (1cm) after being investigated for abdominal pain. He had a past medical history of an abdominal aortic aneurysm (AAA), type 2 diabetes mellitus and hypertension.Investigations: Initial endocrine investigations revealed normal 24h urinary free cortisol levels (twice), metanephrines and ARR. His overnight dexamethasone...

ea0077p232 | Neuroendocrinology and Pituitary | SFEBES2021

Dramatic resolution of a pituitary macroadenoma: non-functioning or prolactin-secreting?

Mohamed Mousa Abdusalam , Ashraf Tanveer , Lessan Nader

Background: Non-functioning pituitary tumours can be associated with a modestly elevated prolactin. Response to dopamine agonist therapy in such cases is unusual. Large macroprolactinomas are associated with much higher prolactin levels and respond well to dopamine agonists.Case: We report a 41-year-old man with a pituitary macroadenoma associated with an elevated prolactin of around 2000mIU/l who developed marked resolution in his pituitary MRI images r...