Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology BES 2022

Harrogate, United Kingdom
14 Nov 2022 - 16 Nov 2022

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SfE BES is returning to Harrogate in 2022. Join with endocrine specialists from across the UK and beyond for the Society for Endocrinology's flagship meeting.

Poster Presentations

Neuroendocrinology and Pituitary

ea0086p88 | Neuroendocrinology and Pituitary | SFEBES2022

Cabergoline in acromegaly – a multicenter, retrospective, cohort study of non-irradiated patients using current criteria for disease control

Urwyler Sandrine A , Samperi Irene , Lithgow Kirstie , Mavilakandy Akash , Matheou Mike , Ayuk John , Bradley Karin , Pal Aparna , Reddy Narendra L , Karavitaki Niki

Background: Cabergoline monotherapy or in combination with somatostatin analogue (SSA) has been reported in few studies with IGF-1-normalization-rates 0%-100%(monotherapy) and 42%-60%(combination therapy). However, in these studies, inclusion of irradiated patients is a potential confounder and currently proposed disease control criteria (normal IGF-1, GH<1 mg/l) have not been applied.Aim: Investigate the efficacy of cabergoline monotherapy or as add...

ea0086p89 | Neuroendocrinology and Pituitary | SFEBES2022

Somatic sequencing in an enriched cohort of recurrent non-functioning pituitary adenomas

MacFarlane James , Clark Graeme , Rodger Fay , Martin Ezequiel , Allinson Kieren , Gurnell Mark , Casey Ruth

Background: Sporadic non-functioning pituitary adenomas (NFPAs) are described as having quiet mutational landscapes. Genes with recurrent somatic alterations have not been identified by previous studies examining heterogeneous pituitary tumour populations. Existing biomarkers have limited ability to discriminate NFPAs with a predisposition for regrowth from those that will follow a more indolent course after primary surgery. We undertook somatic sequencing, in an enriched coho...

ea0086p90 | Neuroendocrinology and Pituitary | SFEBES2022

Phosphoproteomics analysis of aryl hydrocarbon receptor interacting protein (AIP) knockout cells reveals AIP-mediated kinase signalling cascades

Barry Sayka , Rai Ashutosh , Haworth Haworth Oliver , Rajeeve Vinothini , Cutillas Pedro , Korbonits Marta

Introduction: Aryl hydrocarbon receptor interacting protein (AIP) is a multifunctional co-chaperone protein: it behaves as a tumour suppressor in the pituitary, but may have other roles including oncogenic function in other tissues. Protein phosphorylation is an important posttranslational modification that regulates protein activity, which is crucial for understanding protein function. To understand the molecular pathways altered in AIP deficient cells, we have performed glob...

ea0086p91 | Neuroendocrinology and Pituitary | SFEBES2022

Diabetes insipidus safety: Automated electronic records alert to identify patients with diabetes insipidus in hospital

Clave Llavall Anna , Aquino Maia , Teo James , Mustafa Omar G. , Whitelaw Benjamin C.

Background: Cranial diabetes insipidus (DI) is characterised by the inability to produce vasopressin leading to uncontrolled diuresis. Management includes administering synthetic vasopressin analogue desmopressin (DDAVP). Recently, there have been several national reports of DDAVP omission causing serious patient harm. This study aims to evaluate the feasibility of an automated alert system using Natural Language Processing (NLP) in electronic health records (EHR) to detect DI...

ea0086p92 | Neuroendocrinology and Pituitary | SFEBES2022

Natural history of non-functioning pituitary microadenomas – results from the UK NFA consortium

Hamblin Ross , Fountas Athanasios , Lithgow Kirstie , Loughrey Paul Benjamin , Bonanos Efstathios , Khalid Shinwari Shah , Mitchell Kirsten , Shah Syed , Grixti Lydia , Matheou Mike , Isand Kristina , McLaren David , Surya Ashutosh , Zubair Ullah Hafiz , Klaucane Katarina , Jayasuriya Anuradha , Bhatti Sumbal , Mavilakandy Akash , Ahsan Masato , Mathew Susan , Hussein Ziad , Jansz Thijs , Wunna Wunna , Ayuk John , Abraham Prakash , Drake William , Brooke Antonia , Baldeweg Stephanie E. , Sam Amir H. , Martin Niamh , Higham Claire , Reddy Narendra , Ahluwalia Rupa , Newell-Price John , Vamvakopoulos Joannis , Krishnan Amutha , Lansdown Andrew , Murray Robert D , Pal Aparna , Bradley Karin , Mamoojee Yaasir , Purewal Tejpal , Panicker Janki , Marie Freel E , Hasan Faisal , Kumar Mohit , Jose Biju , Hunter Steven , Karavitaki Niki

Background: The published data on the natural history of (presumed) non-functioning pituitary microadenomas (micro-NFAs) is possibly compromised by small sample sizes, short follow-up and inclusion of cases with other pathologies in the analyses.Objective: To clarify the long-term outcomes of micro-NFAs in a large cohort of patients.Methods: We conducted a multi-centre, retrospective, cohort study involving 22 UK endocrine departme...

ea0086p93 | Neuroendocrinology and Pituitary | SFEBES2022

Circadian/diurnal rhythm profiles of serum and salivary melatonin, cortisol and cortisone, determined by liquid chromatography tandem mass spectrometry (LC-MS/MS)

Webb Bethany , Dunn Rachel , Ball Nicole , Fraser William , Lazar Alpar , Michalak Adriana , Voysey Zanna , Tang Jonathan

Background: Melatonin and cortisol production demonstrate circadian rhythms; disruption of these rhythms feature in endocrine and neurodegenerative disorders, such as Addison’s disease, Huntington’s disease (HD) and Alzheimer’s disease (AD). Measuring serum and saliva concentrations at nadir is challenging using immunoassays. We have developed LC-MSMS methods for measuring serum and saliva melatonin, cortisol and cortisone to analyse 24hr profile samples obtained from sleep st...

ea0086p94 | Neuroendocrinology and Pituitary | SFEBES2022

Gene-chromatin regulatory circuits driving stemness in the anterior pituitary

Yianni Val , Lodge Emily J. , Willis Thea L. , Kemkem Yasmine , Zamojski Michel , Mendelev Natalia , Sealfon Stuart C. , Ruf-Zamojski Frederique , Andoniadou Cynthia L.

The pituitary gland is a dynamic organ that adapts its cellular architecture throughout life, making it an ideal model for the study of stem cells (SCs), their commitment and differentiation. Sox2-expressing cells are bona fide anterior pituitary stem cells (PSCs), which through genetic lineage tracing have been shown to give rise to all anterior pituitary hormone-producing cells both in the embryo and adult. The YAP/TAZ signalling pathway has been previously...

ea0086p95 | Neuroendocrinology and Pituitary | SFEBES2022

Optimising the Insulin Tolerance Test: Cortisol Thresholds on Abbott Platforms should be lowered to 416 nmol/L

Hayes Annabel , Choudhury Sirazum , Lazarus Katharine , Meeran Karim

Background: Adrenal insufficiency (AI) is a life-threatening condition which requires long term glucocorticoid (GC) replacement. Patient misdiagnosis results in inappropriate GC use, which has significant adverse effects and is associated with an increased mortality risk. The insulin tolerance test (ITT) is the gold standard test for diagnosis, but the widely accepted cut-off value of ≤550 nmol/l used to diagnose AI is founded on outdated immunoassays. Use of this cut-of...

ea0086p96 | Neuroendocrinology and Pituitary | SFEBES2022

A case of chronic hyponatremia secondary to SIADH treated with low dose Tolvaptan to prevent recurrent hospital admission and proven cost effective

Ahsan Masato , Smurthwaite Hannah , Mani Hamidreza

Introduction: Tolvaptan, a selective vasopressin 2 receptor antagonist is proving beneficial in managing hyponatremia secondary to SIADH.Case report: A 75-year-old male with history of traumatic SAH developed hyponatremia secondary to SIADH. He had multiple admissions with symptomatic hyponatremia. His sodium level kept dropping despite putting on fluid restriction and trial of sodium chloride tablets. He was started on Tolvaptan 7.5 once weekly initiall...

ea0086p97 | Neuroendocrinology and Pituitary | SFEBES2022

Aberrant cyclic GMP-AMP synthase stimulator of interferon genes signalling in an AIP mutant cell line

Benjamin Loughrey Paul , Suleyman Oniz , Begalli Federica , Craig Stephanie G , Hunter Steven J , McArt Darragh G , James Jacqueline A , Haworth Oliver , Barry Sayka , Korbonits Marta

Background: The cyclic GMP-AMP synthase stimulator of interferon genes (cGAS-STING) signalling pathway is an element of the innate immune response and is activated by the presence of DNA in the cytosol. Triggering of this immune response may occur in the setting of infection or neoplasia. Activation of this pathway results in phosphorylation of interferon regulatory factor 3 and downstream transcription of cytokines such as interferon β and interleukin-6. Polyinosinic:pol...

ea0086p98 | Neuroendocrinology and Pituitary | SFEBES2022

The pituitary patients’ experiences pre and during the Covid-19 pandemic

McBride Pat , Brooke Antonia , Charlick James , Newell-Price John , Swindells Pauline , Wass John , Whittingham Pauline , Renwick Ren

Background: Patient experience is a crucial part of patient care, but is not systematically assessed. In light of this we performed a UK-wide survey to understand the care experiences of patients with pituitary conditions over the preceding three years.Methods: In collaboration with patients and pituitary experts a web-based survey was designed, aimed at patients 18yrs and over. Specific topics included: assessment of information provision, communication...

ea0086p99 | Neuroendocrinology and Pituitary | SFEBES2022

Pseudo-Cushing’s syndrome in the context of intense physical exercise and underlying eating disorder - pitfalls of interpreting investigations in patients with body dysmorphia

Sen Gan Yu , Zeitoon Saed , Nag Sath

Introduction: Pseudo-Cushing’s syndromes are a heterogeneous group of disorders and include alcoholism, obesity, anorexia nervosa (AN), depression and intense physical exercise. These share biochemical features of Cushing’s syndrome (CS) causing ACTH-dependent hypercortisolism. Distorted body image is a prominent feature of eating disorders. We describe the case of patient with AN who was convinced she had CS. This led to investigations that confirmed hypercortisolis...

ea0086p100 | Neuroendocrinology and Pituitary | SFEBES2022

Adipose tissue and glycemic changes in patients with surgically treated acromegaly

Livia Gheorghiu Monica , Maria Prunariu Ana , Maria Lider Burciulescu Sofia , Purice Mariana , Iordachescu Carmen

Introduction: Excess GH in acromegaly has lipolytic action and detrimental effect on glucose metabolism and insulin signaling. Recent studies have suggested a specific lipodystrophy in patients with acromegaly. Paradoxically, although the visceral adipose tissue (VAT) and intrahepatic lipid were reduced in active acromegaly compared to controls, insulin resistance was increased. Fat was redistributed from subcutaneous and visceral depots to muscle; weight and VAT depots rose w...

ea0086p101 | Neuroendocrinology and Pituitary | SFEBES2022

A rare case of silent Gonadotroph Adenoma presenting with secondary infertility, oligomenorrhea in a female patient with a history of polycystic ovarian syndrome

Tabasum Maria , Tariq Sadia , Afridi Saima , Adnan Shafqat Syed , Serfraz Rabeeya , Malik Shiraz , Ogunko Arthur , Fidelis Abedo Itopa

Background: Gonadotroph adenomas are usually clinically non-functioning and hypersecretion of FSH or LH is unusual, and no distinct hormone-dependent clinical phenotype is present. Positive immunostaining for nuclear transcription factor SF1 is usually sufficient to diagnose gonadotroph adenoma.Case History: A 37-year-old lady with Asian background presented with tiredness, headaches, weight gain, poor sleep, secondary amenorrhea and infertility for 2 ye...

ea0086p102 | Neuroendocrinology and Pituitary | SFEBES2022

Early Onset Neurosarcoidosis with Delayed Severe Hypercalcaemia

Mohamed Abdelhamid , Ali Mohamed , Mustafa Rehan , Nag Sath

Sarcoidosis is a multiorgan disease often affecting the lungs and lymphatic system. Neurological involvement occurs in sarcoidosis as granulomas infiltrate the nervous system. Here, we present a case of neurosarcoidosis diagnosed following non-specific neurological symptoms and delayed hypercalcaemia. A 32-year-old female presents with headaches, vomiting and acute confusion. During admission she developed unresponsive episodes. She has a background of type 1 diabetes and hypo...

ea0086p103 | Neuroendocrinology and Pituitary | SFEBES2022

A rare case of Erdheim-Chester disease as the underlying cause of cranial diabetes insipidus

Brain Eleanor , Nag Sath

Introduction: Erdheim-Chester disease is a rare form of non-Langerhans’ cell histiocytosis characterised by foamy histiocyte infiltration with multi-systemic manifestations. Roughly 550 cases have been described in the literature, most frequently affecting men aged 40-60. Bony pain is the most common symptom, resulting from osteosclerotic lesions of the long bones of the lower limbs. Extra-skeletal manifestations are varied and include diabetes insipidus resulting from pi...

ea0086p104 | Neuroendocrinology and Pituitary | SFEBES2022

Patient-reported use of physiotherapy services in rare endocrine conditions – a quantitative study

Marshall Stephanie , Cook Katherine

Background: Recent research on experiences of adults with a rare endocrine condition/disease (RED) indicate a preference for greater access to allied health professionals including physiotherapists.Objective: To explore experiences of musculoskeletal (MSK) symptoms (typically managed by physiotherapy) of adults living with a RED and investigate their reported usage and satisfaction of MSK physiotherapy services.Method: Ethically ap...

ea0086p105 | Neuroendocrinology and Pituitary | SFEBES2022

Case Series: Primary / neo-adjuvant 131I-MIBG therapy as a safe and effect treatment in the management of pheochromocytoma / paraganglioma

Onyema Michael , Crane James , Reynolds Saira , Whitelaw Benjamin

Background: As per 2014 Endocrine Society guidelines, 131I-MIBG therapy is usually reserved for metastatic or unresectable disease in patients with pheochromocytoma / paraganglioma. In this series, we describe three patients effectively treated with primary 131I-MIBG therapy. The indications were primary neo-adjuvant therapy prior to surgery, or palliative.Case series: Case 1 – 18-year-old male with a 60 mm para-aortic paragang...

ea0086p106 | Neuroendocrinology and Pituitary | SFEBES2022

Identifying and characterising variants in patients with pachydermoperiostosis

Angurala Ishita , Barry Sayka , Rice Tom , Magid Kesson , Rai Ashutosh , Benjamin Loughrey Paul , Dutta Pinaki , Stelmachowska Banaś Maria , Korbonits Marta

Introduction: Pachydermoperiostosis (primary hypertrophic osteoarthropathy, PHOA) is a rare genetic condition characterised by digital clubbing, pachydermia, hyperhidrosis, cutis verticis gyrata and periostosis. The SLCO2A1 transporter and HPGD enzyme genes play an important role in prostaglandin metabolism, hence loss of function mutations in them causes PHOA. To date, according to the VarSome database 101 and 41 variants have been identified in the SLCO...

ea0086p107 | Neuroendocrinology and Pituitary | SFEBES2022

Severe hyponatremia-A manifestation of new Pituitary metastases in Renal Cell Cancer

Abouglila Kamal , Hassaan Pervez Muhammad , Owaydah Amal

It is very rare to have Pituitary metastasis in Renal Cell cancer (RCC). Prevalence of Pituitary metastasis varies from 1-4% in all cancers and about 2.6% in RCC. Most common cancers with pituitary metastasis are breast (33%) and lung (36%). We present a rare case of RCC with pituitary Metastasis presented with severe Hyponatraemia. A 71 years old male with history of renal cell cancer who underwent Right nephrectomy in 2017. He was found to have intrathoracic metastases in 20...

ea0086p108 | Neuroendocrinology and Pituitary | SFEBES2022

Dopamine agonist intolerance in prolactinoma- A management challenge to endocrinologist

Wellala Vindya , Machenahalli Pratibha , Kumarathunga Dineesha , Georgios Giovos , Puja Thadani

Introduction: Typically, patients with a microprolactinoma will have serum prolactin level between 2,000-4,000mIU/l. The primary goal of treatment is to normalise prolactin level and thereby improve symptoms associated with a raised prolactin. Dopamine (D2) agonists are the main stay of treatment with some patients unable to tolerate dopamine agonists rather than being resistant to the medication.Case report: A 26-year-old lady with a history of anxiety ...

ea0086p109 | Neuroendocrinology and Pituitary | SFEBES2022

A TSH-secreting pituitary adenoma cured from SSA monotherapy alone: Disease free more than three years after stopping treatment

Bhavra Kirandeep , Hamblin Ross , Ayuk John , Boelaert Kristien , Karavitaki Niki

Introduction: TSH-secreting pituitary adenomas (TSHomas) are rare pituitary tumours treated primarily with surgery; in cases of surgical failure, somatostatin analogue (SSA) or radiotherapy are further options. SSAs are rarely used as monotherapy; if responsive and in the absence of radiotherapy, the requirement of life-long medical treatment, is unknown. Herein, we present a patient with a TSHoma who remains in remission three years after SSA withdrawal.<p class="abstext"...

ea0086p110 | Neuroendocrinology and Pituitary | SFEBES2022

Retrospective analysis of clinical, biochemical, radiological features of Craniopharyngioma

Pratibha Machenahalli C , Iqbal Asif , Shad Amjad , Smith Megan , Woods Leanne , Brown Ian , Randeva Harpal

Craniopharyngioma is a rare embryonic malformation of the Sellar/parasellar region. This harbors BRAF-V600E mutations. There are 2 Subtypes-Adamantinomatous and Papillary. Point prevalence of CP is around 2/100,000 with no variance by gender or race. CP has bimodal age distribution with peak incidence in the ages of 5-14 and 65-74 years. CP presents with following clinical features: Symptoms due to increased intracranial pressure-Nausea, headaches, visual impairments, hormone ...

ea0086p111 | Neuroendocrinology and Pituitary | SFEBES2022

A rare Presentation of Carcinoid Crisis Following Radioactive Iodine Treatment for Thyroid Cancer in a Patient with Metastatic Midgut Neuroendocrine Tumour

Elamin Aisha , Hussein Ziad , Wadsley Jonathan

Introduction: Carcinoid crisis represents a rare medical emergency with potentially fatal manifestations that can occur in patients with neuroendocrine tumours (NETs). The condition is caused by a substantial release of vasoactive metabolites from the NETs during diagnostic or therapeutic interventions. However, in rare instances, it can occur spontaneously. Here, we report a patient who developed a carcinoid crisis following radioactive iodine131I (RAI) treatment f...

ea0086p112 | Neuroendocrinology and Pituitary | SFEBES2022

Primary papillary epithelial tumor of the pituitary- a challenge to diagnosis; first reported case from Sri Lanka

Kumarathunga P.A.D.M. , De Silva W.M.A.S , Rathnayaka Palitha , Antonypillai Charles

Background: While pituitary adenomas are the commonest Sella neoplasm, number of other entities should be considered in the differential diagnosis and the diagnosis is based on histopathological and immunohistochemical characteristics. Pituitary tumors with papillary architecture are uncommon and have limited differential diagnoses. Primary papillary epithelial tumor of the pituitary is a recently described histopathological entity with striking papillary architecture and TTF1...

ea0086p113 | Neuroendocrinology and Pituitary | SFEBES2022

A Rare Case of Radiation-Induced Sarcoma in Acromegaly – Diagnostic challenges

Basavaraju Navya , Shaw Simon , Varadhan Laks , Ayuk John , Saravanappa Natarajan , Jose Biju

Introduction: Acromegaly is a rare, progressive disease characterised by excess growth hormone. The recommended treatment is surgery. Radiotherapy and somatostatin analogues are used as adjuncts. The risk of post-radiotherapy osteosarcoma is 0.01% to 0.03% among all irradiated patients. We report a case of radiation-induced osteosarcoma that developed 22 years after radiotherapy for acromegaly.Case report: In 1997, a 53-year-old gentleman with acromegaly...

ea0086p114 | Neuroendocrinology and Pituitary | SFEBES2022

Skull base lymphoma causing hypopituitarism

Shah Preet , Gonzalez Susana

A 69-year-old lady presented to the ophthalmologists in view of a right 6th cranial nerve palsy and headache. Neuroimaging showed a central and right sided base of skull tumour with involvement of multiple cranial nerves (3rd, 4th, 6th). An endoscopic biopsy was inconclusive. She presented to the medical team few days later with drowsiness, lethargy, and her sodium was found to be 117 mmol/l with a potassium of 5.5 mmol/l. Serum osmolality was 267 mOsm/kg, urine osmolality was...

ea0086p115 | Neuroendocrinology and Pituitary | SFEBES2022

Pituicytoma mimicking as a Non-functioning pituitary macroadenoma

Kumarathunga P.A.D.M. , Machenahalli Pratibha , Shad Amjad , Smith Megan , Thadani Puja , Wellala A.V.H. , Randewa Harpal

Background: Pituitary adenomas are the commonest Sellar neoplasm, there are number of other differential diagnosis based on histopathological features and immune histochemical characteristics. Pituicytomas are rare tumours of sellar and suprasellar region which originate from pituicytes which are specialised glial cells of neurohypophysis and infundibulum.Case report: A 63-year-old lady with a background history of bilateral cataract corrected with surge...

ea0086p116 | Neuroendocrinology and Pituitary | SFEBES2022

Insulinoma presenting as Seizures - Case Report of a 16-year-old young woman

Soyoye David , Atolani Olusegun , Adetunji Tajudin , Owolabi Funmilayo , Alatise Olusegun , Ikem Rosemary , Kolawole Babatope

Introduction: Insulinomas are rare pancreatic neuroendocrine tumours (PETS), which are usually benign and sporadic. They secrete insulin, and hence present with hypoglycaemia. We report a case of insulinoma presenting as seizures.Case Presentation: The patient, a 16-year-old female, first had an episode of convulsion a year prior to referral to the Endocrine Clinic. She was managed at a private clinic with intravenous fluid (name unknown) and later comme...

ea0086p237 | Neuroendocrinology and Pituitary | SFEBES2022

Acetate ameliorates depressive-like behaviour in a rat model of PCOS through suppression of HDAC2 expression and DNA methylation

Olaniyi Kehinde , Areloegbe Stephanie

Background: Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. PCOS has been demonstrated to induce depressive-like behavior. Epigenetic alterations such as histone deacetylation (HDAC) and DNA methylation have been suggested in major depression. However, their effects with respect to neuroinflammation are not clear. This study, therefore, investigated the pathogenic role of epigenetic modification in PCOS-associated depre...

ea0086p238 | Neuroendocrinology and Pituitary | SFEBES2022

Anticoagulation practice for venous thromboembolism prophylaxis in patients with Cushing’s Syndrome - a Society for Endocrinology survey of UK Centres

Isand Kristina , Plummer Zoe E , Volke Vallo , Newell-Price John , Wass John , Pal Aparna

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...

ea0086p239 | Neuroendocrinology and Pituitary | SFEBES2022

A zebrafish model of AIP loss of function

Wang Xian , Leggieri Adele , Anagianni Sofia , Brennan Caroline H. , Korbonits Marta

Background: Aryl hydrocarbon receptor-interacting protein (AIP) has been identified as a tumour suppressor gene in pituitary gland, causing 10% of all familial isolated pituitary adenoma. Patients with heterozygous loss-of-function germline mutation of AIP develop young-onset growth hormone and/or prolactin-secreting pituitary tumours. Homozygous loss of AIP leads to embryonic lethality in several animal models (mouse, fruit fly, round worm). Mouse e...

ea0086p240 | Neuroendocrinology and Pituitary | SFEBES2022

UK practice on incidental (presumed) non-functioning pituitary microadenomas: a 13-year interval comparison

Hamblin Ross , Fountas Athanasios , Levy Miles J , Karavitaki Niki

Introduction: The optimal management approach for incidental non-functioning pituitary microadenomas (micro-NFAs) is unclear. We aimed to capture current UK practice and identify changes following a 13-year interval.Methods: Two surveys on micro-NFAs were conducted in 2009 and 2022 (advertised by Society for Endocrinology). Hormonal/imaging evaluations were explored.Results: 2022: 150 clinicians participated. At baseline, ≥14...

ea0086p241 | Neuroendocrinology and Pituitary | SFEBES2022

Understanding the molecular pathophysiology of stress on the developing and adult brain

Oberski Lara

The hypothalamic-pituitary-adrenal (HPA) axis is the main stress-responsive neuroendocrine system in humans. Glucocorticoids (GC) constitute the principal systemic mediators of HPA axis function by governingmetabolic and behavioural responses to stress. Those include the modulation of transcriptional processes through the coordinated action of glucocorticoid (GR) and mineralocorticoid (MR) receptors. To study the effects of systemic malfunctioning of the HPA axis on the develo...

ea0086p242 | Neuroendocrinology and Pituitary | SFEBES2022

FUZ is required for SHH-mediated pituitary development

Lodge Emily , Barrell William , Liu Karen , Andoniadou Cynthia

The primary cilium of cells detects and transduces extracellular signals, in particular, amplifying the SHH pathway, a key pathway required for pituitary development. FUZ is a planar cell polarity (PCP) effector, which is essential for normal ciliogenesis, required for recruiting retrograde intraflagellar transport proteins to the base of the organelle. The primary cilia of Fuz-/- mutants are shorter or non-functional. Previous work has reported ciliopathy ...

ea0086p243 | Neuroendocrinology and Pituitary | SFEBES2022

Imaging surveillance of completely resected gastroenteropancreatic neuroendocrine tumors is associated with high levels of radiation exposure

Ianuzzi Jordan , Yeo Caitlin , Parkins Vicky , Pasieka Janice , Ruether Dean , Chan Denise , Albalawi Zaina , Stewart Errol , Lithgow Kirstie

Background & Aims: Neuroendocrine tumours (NET) are a heterogenous group of neoplasms that secrete peptides and neuroamines. For potentially malignant gastroenteropancreatic (GEP) NET, surgical resection represents the only curative option. Ten-year imaging surveillance programs using cross sectional imaging are recommended due to long time-to-recurrence following resection. We performed a retrospective chart review to evaluate radiation exposure associated with surveillan...

ea0086p244 | Neuroendocrinology and Pituitary | SFEBES2022

Neuroendocrine tumour (NETs) patient experience of switching to generic somatostatin analogue during the COVID-19 pandemic

Solanke Faith , Elamin Aisha , Newell-Price John , Munir Alia , Ibbotson Victoria

Introduction: In patients with neuroendocrine tumours (NETs) somatostatin analogues are used to control symptoms in patients with functioning tumours and as antiproliferative agents in those with non-functioning tumours. During COVID-19, the ‘Sandostatin Your Choice’ service was terminated by Novartis, removing home care nurses from administering the analogue in patients’ homes. The first generic version of depot octreotide was Olatuton® produced by Teva, a...

ea0086p245 | Neuroendocrinology and Pituitary | SFEBES2022

An investigation into discrepancies between serum insulin-like growth factor 1 (IGF-1) concentrations and clinical presentation in the assessment of acromegaly

Miler Emma , McMurray Susanne , McArdle Nicholas , Ahluwalia Rupa , Chipchase Allison

Background: The suitability of serum insulin-like growth factor 1 (IGF-1) reference ranges (RR) used locally (manufacturer-derived), were raised as a clinical concern. IGF-1 levels above the RR were reported in patients displaying no clinical signs or symptoms of acromegaly, and in whom growth hormone suppression tests were negative. No analytical issue was evident, and quality performance indicators were satisfactory.Methods: A review of all serum IGF-1...

ea0086p246 | Neuroendocrinology and Pituitary | SFEBES2022

A novel presentation of primary hyperparathyroidism for the Val804Met mutation

Yadav Jahnavi , Mehta Rubin , Avari Parizad , Freudenthal Bernard , Mulla Kaenat , Mistry Kieran , MacEacharn William , Cox Jeremy

Background: Multiple endocrine neoplasia type 2 (MEN2) is a group of pleomorphic syndromes which infer a susceptibility to several endocrine conditions. The RET Val804Met mutation is classified as a moderate-risk mutation for familial medullary thyroid cancer (MTC), without the other components of MEN2 syndromes. However, here we describe a rare case of a gentleman with RET p.V804M, presenting with primary hyperparathyroidism (PHPT) and no evidence of MTC.<p class="abstext...

ea0086p247 | Neuroendocrinology and Pituitary | SFEBES2022

Surgical management of prolactinomas in patients with dopamine agonist-associated impulse control disorders or who are deemed at ‘high risk’

T. C. Yu Arthur , Wernig Florian , Meeran Karim , Martin Niamh , Mendoza Nigel , Nair Ramesh , Jones Brynmor , Gontsarova Anastasia , Behary Preeshila

Introduction: Prolactinomas are the commonest type of secretory pituitary tumours. In current practice, dopamine agonists (DA) remain the mainstay treatment. However, treating physicians are increasingly aware of DA-associated impulse control disorders (ICD) in their patients. We describe 4 individuals with prolactinomas, who either developed ICD on DA or deemed at ‘high risk’, successfully managed surgically with preservation of pituitary function. All decisions for...

ea0086p248 | Neuroendocrinology and Pituitary | SFEBES2022

Vasopressin in Not a Strong Stimulus for ACTH-Cortisol Secretion In Humans

Lewandowski Krzysztof , Malicka Katarzyna , Lewiński Andrzej

Background: Vasopressin, secreted in equimolar amounts with copeptin, is implicated as a stimulus for ACTH secretion during dynamic tests, such as Glucagon Stimulation Test (GST) or Insulin Tolerance Test (ITT). Some individuals with intact ACTH-cortisol axis, demonstrate, however, a lack of further cortisol stimulation during GST. We have assessed whether failure of further ACTH-cortisol increase during GST may be associated with an inadequate vasopressin/copeptin release.</p...

ea0086p249 | Neuroendocrinology and Pituitary | SFEBES2022

Acute hypoglycemia as the presenting manifestation secondary to pituitary metastasis in a patient with malignant melanoma

Sahoo Saroj , Eltayeb Randa , Islam Quazi , Naeem Ammara , Patel Dipesh , Yousseif Ahmed , Armeni Eleni , Karra Efthimia , Khoo Bernard , Grossman Ashley

Introduction: Pituitary metastasis (PM) is a rare condition and associated with a reduced life-span. The most common primary sites are breast and lung, followed by thyroid and renal cell carcinoma. Patients with PM are mostly asymptomatic and incidentally discovered during neuroimaging. Characteristic symptoms are reported in <20% and most commonly include visual involvement, diabetes insipidus, and panhypopituitarism. We here describe a case with malignant melanoma (MM) w...

ea0086p250 | Neuroendocrinology and Pituitary | SFEBES2022

A case report of Takotsubo cardiomyopathy associated with pituitary apoplexy

Setty Naveen , Hasan Faisal , Parfitt Vernon

Background: We present a rare diagnosis of a patient presenting with Takotsubo cardiomyopathy and pituitary apoplexy. The case highlights the difficulty in management of a cardiac event with bleeding risk in a patient with these associated diagnoses.Case report: An 85-year-old woman was admitted to hospital with a severe frontal headache that woke her from sleep. She described chest pain associated with breathlessness later and was mildly confused. Sadly...

ea0086p251 | Neuroendocrinology and Pituitary | SFEBES2022

ACTH dependent Cushing’s syndrome due to a pituitary macroadenoma presenting with acute Type B aortic dissection, severe hypercortisolism and resistant hypertension

Goldstein Dovid , Platts Stephen , Mofidi Reza , Varma Anil , Nag Sath

Introduction: Cushing’s syndrome is a known risk factor for aortic dissection but the association of these conditions is rare. Hypercortisolism is associated with an increased risk of cardiovascular disease and accounts for the high morbidity & mortality in untreated patients.Case Study: A 64y old male presented with acute onset chest pain, radiating to the back. CT angiogram showed Stanford Type B dissection involving the distal aortic arch/des...

ea0086p252 | Neuroendocrinology and Pituitary | SFEBES2022

Impulse Control Disorder in Patients on Dopamine Agonist

Guma Muna , Mamoojee Yasser

Background: Dopamine agonists (DA) remain the first-line medical therapy for prolactinomas and idiopathic hyperprolactinemia in Endocrinology. DA can also be efficacious in a selected group of patients with acromegaly. There is increasing awareness, among endocrinologists, of Impulse Control Disorders (ICDs) as possible adverse effects of DA therapy.Case reports: We describe ICDs in four patients (two diagnosed with prolactinoma and two diagnosed with ac...

ea0086p253 | Neuroendocrinology and Pituitary | SFEBES2022

Safe Reduction in Short Synacthen Testing to Assess Hypothalamo-Pituitary Axis in patients on Corticosteroids

Ullah Hidayat , Nair Narmadha , Buch Harit , Chopra Roopa , Okeke Victor , Kalaria Tejas

Background: Short Synacthen Test (SST) is widely used to assess hypothalamic-pituitary-adrenal (HPA) axis in patients on corticosteroids. This requires significant material and human resources especially as patients often require multiple tests. We performed a retrospective cohort study, followed by the implementation of QIP methodology to reduce the number of SST in this cohort of patients.Methodology: We reviewed 167 patients who had a SST and derived ...

ea0086p254 | Neuroendocrinology and Pituitary | SFEBES2022

Prevalence of cancer in a cohort of acromegaly patients

Trifanescu Raluca , Toma Iustin , Dumitrascu Anda , Goldstein Andrei , Poiana Catalina

Background: Growth hormone directly stimulates tumour growth, angiogenesis and metastasis through autocrine and paracrine effects on cancer cells, while through IGF1 inhibits apoptosis and promotes epithelial proliferation. Although disputed, some studies have shown an increased cancer incidence in acromegaly patients, especially in uncontrolled subjects, while others have not.Aim: To assess prevalence of cancer in a cohort of patients with long term tre...

ea0086p255 | Neuroendocrinology and Pituitary | SFEBES2022

Pituitary mass and Pan hypopituitarism- A rare case of Langerhans Cell Histiocytosis

Hassaan Pervez Muhammad , Abouglila Kamal

Langerhans cell Histiocytosis is a rare neoplastic histiocytic disorder. It has broad spectrum of clinical presentations from single system to multi system. It mainly affects children but can occur in adults. It can present with skin lesions, skull/jaw tumours, polyuria/polydipsia, fever, cough and dyspnea, bone pain, ataxia etc. 25% of adult cases involve Pituitary (anterior and posterior pituitary gland) and hypothalamus. BRAF and MAP2K1 mutations are most ...

ea0086p256 | Neuroendocrinology and Pituitary | SFEBES2022

Two cases of acromegaly: the role of the dentist in early detection

Z Htun Kyaw , Sagi Satyanarayana V , Rajkanna Jeyanthy , Goindoo Ryan J , Oyibo Samson O

Introduction: Acromegaly is a rare metabolic condition in adults caused by over secretion of growth hormone from the pituitary gland. The characteristic skeletal and organ overgrowth and dental mal-occlusion issues are so insidious that they go unnoticed by the patient and family. The dentist may be the first healthcare provider to see these patients, thereby proving instrumental in early diagnosis. We report two cases of acromegaly: one case identified by a dentist and anothe...

ea0086p257 | Neuroendocrinology and Pituitary | SFEBES2022

The modulatory role of curcumin and quercetin on Drosophila GSK-3: a potential therapeutic intervention in Parkinson’s disease

Olanrewaju John , Russell Steve

Aim: We explored the mechanistic interactions and potential therapeutic benefits of curcumin and quercetin co-administration with a specific focus on Glycogen synthase kinase 3 GSK-3 activity.Methods: We hypothesize that excess GSK-3 accumulation in the substantia nigra is driven by oxidative stress and aim to test the effects of these compounds on the localization and activity of GSK-3 in the well-established model organism Drosophila melanogaster. We p...

ea0086p258 | Neuroendocrinology and Pituitary | SFEBES2022

Unusual presentation of neurohypophysitis

Shrikrishna Kushe Manish

35-year lady with BMI of 43 was admitted to local hospital after acute shortness of breath. History of Right calf pain and swelling was evident which raised suspicion of VTE with high likelihood of Pulmonary Embolism. Subsequent CT Pulmonary Angiogram confirmed the same with origin of clot from her leg DVT. She had successfully thrombolysis in intensive care as per hospital protocol. Her high body mass index was thought to be risk factor for blood clots. Her periods were regul...

ea0086p259 | Neuroendocrinology and Pituitary | SFEBES2022

Successful use of recombinant human TSH prior to radioiodine therapy in an acromegaly patient with differentiated thyroid cancer and pituitary insufficiency

Toma Iustin , Trifanescu Raluca , Goldstein Andrei , Dumitrascu Anda , Poiana Catalina

Background: Differentiated thyroid cancer (DTC) is the most common endocrine malignancy. Standard treatment includes thyroidectomy (extention depending on tumour size, pathology and lymph nodes involvement). If indicated, radioiodine therapy after TSH stimulation either by levothyroxine withdrawal or rhTSH administration is recommended. In patients with thyrotropin deficiency rhTSH administration is mandatory.Case report: A 30-year-old woman, resident in...

ea0086p260 | Neuroendocrinology and Pituitary | SFEBES2022

Cushing’s Syndrome – A medical emergency and diagnostic challenge

Thadani Puja , Chaudhury Nadia , Murthy Narasimha , Rao Ranganatha , Randeva Harpal , Weickert Martin , Gholap Nitin

Background: Ectopic Cushing’s syndrome (ECS) is a rare and severe condition at times presenting acutely with intense hypercortisolism. The intensity of hypercortisolism can be disproportionate to underlying tumoral condition, and associated life-threatening complications are common arising suddenly. Hypercortisolism must be controlled rapidly pending definitive treatment of tumoral source to avoid life-threatening consequences.Case Summary: 31-year-...

ea0086p261 | Neuroendocrinology and Pituitary | SFEBES2022

A rare case of multicentric glioblastoma causing panhypopituitarism: A case report

Shafiq Shahriar , Sim Yi Tao , Thayyil Sheena , Gohil Shailesh , Bhake Ragini , Reddy Narendra L , Scott Ian , Robertson Iain , Levy Miles

Introduction: Glioblastoma, an aggressive intracranial tumour usually is a solitary lesion and not commonly located in the sella turcica. Panhypopituitarism due to multicentric glioblastoma can present with a challenging clinical picture masking or delaying the underlying diagnosis. Case presentation: 58 year old female presented with marked behavioural change, reduced appetite, nausea, polyuria & increased thirst over 4-6 weeks precipitating into an...

ea0086p262 | Neuroendocrinology and Pituitary | SFEBES2022

Dilated Cardiomyopathy as initial presentation of Acromegaly

Alnuaimi Abdulla , Alameri Majid , Ward Helen , Hatfield Emma , Martin Niamh , Meeran Karim

Introduction: Acromegaly is commonly associated with numerous cardiovascular manifestations such as left ventricular hypertrophy, hypertension and ischemic heart disease. However, initial presentation with dilated cardiomyopathy is relatively rare. Dilated cardiomyopathy in patients with acromegaly usually result from an extended and excessive exposure of the myocardium to growth hormone.Case presentation: 51-year-old female with background medical histo...

ea0086p263 | Neuroendocrinology and Pituitary | SFEBES2022

Pitfalls in the Biochemical Evaluation of Cushing’s Syndrome: A Challenging Case and Literature Review

Hughes Christopher , Laing Ian , Rajgopal Ranjith , Khor Xiao , Howell Simon , Kaushal Kalpana

A 47-year-old female presented with facial swelling, easy bruising, and concern regarding possible Cushing’s syndrome. She had developed secondary amenorrhoea 3 years previously; biochemistry suggested hypogonadotrophic hypogonadism, felt to be hypothalamic secondary to low BMI and intense exercise. She was normotensive, and BMI was 17.4. There was no evidence of abdominal striae, proximal myopathy or hirsutism, but her face appeared rounder and plethoric compared with a ...

ea0086p264 | Neuroendocrinology and Pituitary | SFEBES2022

Diabetes insipidus following a non-acute presentation of pituitary apoplexy – a rare presentation

Bastawrous Madona , Bhagi Ridhi , Roy Chowdhury Sharmistha , Cozma Lawrence

Introduction: Pituitary apoplexy (PA) is a rare endocrine emergency with less described entity being its subacute/non-acute presentation. Incidence of PA is difficult to determine, varying 2%-12% of pituitary adenoma. Hypopituitarism in PA is observed in up to 70% of cases with diabetes Insipidus (DI) observed in <5% of cases and mostly transient.Case description: 82-year old female with pituitary macroprolactinoma (1.5 cm) presented with 3-week hist...

ea0086p265 | Neuroendocrinology and Pituitary | SFEBES2022

Not just a prolactinoma- Conservative management of co-secretory macroadenoma

Sharma Bhavna , Vanieri Erika , Deore Mahesh , Rahman Mushtaqur , Qureshi Asjid , Garg Ranjna

45 years old male of Romanian origin presented with shortness of breath and reduced exercise tolerance over 3 months with increased sweating and weight gain from 90 kgs to 118 kgs over 2 years. Also reported hands/fingers/feet size increase. He also complained that his breathlessness worse by as tongue and lips were ‘large’. Denied any visual disturbance, especially peripheral vision. On examination, coarse features, prognathism and possible macroglossia noted. Photo...

ea0086p342 | Neuroendocrinology and Pituitary | SFEBES2022

Variants in the neurodevelopmental gene bone morphogenetic protein/retinoic acid inducible neural-specific 2(BRINP2) are associated with severe delayed puberty

Al-Sayed Yasmin , Howard Sasha

Gonadotropin-releasing hormone (GnRH) is the master hormone regulating the reproductive axis and its pulsatile secretion is crucial for puberty onset and fertility. Disruption in GnRH neuron development or hypothalamic function can lead to absent or delayed puberty (DP) due to GnRH deficiency, with a phenotypic spectrum from severe delayed puberty to partial or complete Hypogonadotropic Hypogonadism (HH). HH can also be present as a shared trait with other neurodevelopmental d...

ea0086p343 | Neuroendocrinology and Pituitary | SFEBES2022

Variants in Methyl-CpG-binding protein 2 (MECP2) are associated with X-Linked Central Precocious Puberty

E Read Jordan , Pinheiro-Machado Canton Ana , Tinano Flavia , Guasti Leonardo , Ribeiro Montenegro Luciana , Ryan Fiona , Shears Deborah , Paganoni Alyssa , Korbonits Marta , Jorge Alexander , David Alessia , Bilharinho Mendonca Berenice , Nahime Brito Vinicius , Claudia Latronico Ana , Howard Sasha R

Whilst several key genetic contributors to the phenotype of central precocious puberty (CPP) have been recognized, many familial cases remain without a clear genetic aetiology. Methyl-CpG-binding protein 2 (MECP2) is a chromatin-associated transcriptional regulator, which plays an essential role in neuronal maturation. It is encoded by the MECP2 gene, located at chromosome Xq28, which is highly expressed in brain tissues. Loss-of-function mutations in MECP2 are usually associa...

ea0086p344 | Neuroendocrinology and Pituitary | SFEBES2022

CRN04894: an oral, nonpeptide adrenocorticotropic hormone (ACTH) receptor antagonist decreases basal and stimulated cortisol secretion in healthy volunteers

Trainer Peter , Ferrara-Cook Christine , Ayala Alejandro , Luo Rosa , Miller Stephanie , Wang Yang , Hernandez-Illas Martha , Scott Struthers R. , Betz Stephen , Krasner Alan

CRN04894 is a potent, orally bioavailable nonpeptide that is a highly selective antagonist for melanocortin type 2 receptor (MC2R). This receptor is found exclusively in the adrenal cortex and is the primary mediator of adrenal activation. We report results from a randomized, double-blinded, placebo-controlled (6 active:3 placebo/cohort), multiple ascending dose (40, 60, and 80 mg) study in health volunteers evaluating safety, pharmacokinetics, and pharmacodynamics of oral, on...

ea0086p345 | Neuroendocrinology and Pituitary | SFEBES2022

Amyloid Beta Expression in the Amygdala of Aged Rhesus Macaques: Effect of Hormone Replacement Therapy

Urbanski Henryk , Appleman Maria-Luisa , Nilaver Benjamin , Kohama Steven

Amyloid beta (Aβ) plaques represent one of the classic hallmarks of Alzheimer’s disease (AD) pathology in the brain. In rhesus macaques, these plaques start becoming prominent when the animals are 20+ years old, although the underlying cause(s) are unclear. In the present study, our goal was to test the hypothesis that exposure to a Western-style, high-fat, high-sugar diet (WSD) and/or loss of ovarian steroids would advance the development of this histological marker...

ea0086p346 | Neuroendocrinology and Pituitary | SFEBES2022

Immune checkpoint inhibitor related hypothalamus pituitary adrenal axis dysfunction: A retrospective study in Derriford Hospital

Gardner Gemma , Hirwa Kagabo , Pyone Khine May , Patel Nishchil , Edeghere Simon , Flanagan Daniel

Background: Newer biological drugs such as immune checkpoint inhibitors (ICI) have recently revolutionized cancer therapy. However, hypophysitis and adrenalitis are recognized side-effects of these new therapies. Hypothalamus pituitary adrenal (HPA) axis dysfunction is associated with serious morbidity and mortality. This study aimed to monitor whether the ICI related HPA axis dysfunction recovers.Materials and Methods: We have conducted a retrospective ...

ea0086p347 | Neuroendocrinology and Pituitary | SFEBES2022

Targeted Profiling of Endogenous Steroids in Mouse Plasma Using Liquid Chromatography-Mass Spectrometry Approach

Gazarkova Taťana , Plachka Kateřina , Kočova Vlčkova Hana , Novakova Lucie , Svec Frantisek

Stress is increasingly pervasive in modern society and an unavoidable stimulus to the human organism. Stressors, whether of social or physical type, activate the hypothalamic-pituitary-adrenal (HPA) axis, resulting in the upregulation of glucocorticoid levels and, in some cases, its de novo biosynthesis. Aside from HPA axis regulation, corticosteroids also modulate the immune response to inflammation and affect the whole-body metabolism. Accurate quantification of endogenous s...

ea0086p348 | Neuroendocrinology and Pituitary | SFEBES2022

Use of Neurosteroids to Treat a Neuronal Antibody-mediated Seizure Model

Upadhya Manoj , Dias Irundika , Wright Sukhvir

Background: NMDAR-Ab mediated encephalitis is a neuro-immunological disorder that presents with seizures. NMDAR-Abs cause internalisation of NMDARs while Pregnenolone sulfate (PregS) a neurosteroid upregulates NMDARs in the brain. Our previous in vitro studies have shown that PregS can reduce established ictal activity caused by NMDAR-Abs (Wright et al., 2021). Before proceeding with in vivo treatment studies, we aimed to determine baseline brain PregS levels...

ea0086p349 | Neuroendocrinology and Pituitary | SFEBES2022

Co-morbidity of alzheimer-like dementia and type-2 diabetics mellitus: possible therapeutic effect of virgin coconut oil

Olaseni Victoria , Olarewaju John , Soremekun Dimeji , Afolabi Toluwanimi

Alzheimer’s disease is a progressive disease of the human brain characterized by memory impairment and disturbance in at least one other thinking function. Type 2 diabetes (T2D) is the kind of diabetes mellitus (DM) that occurs due to the absence or deficiency of insulin receptors and it is usually referred to as maturity-onset DM. The hippocampus, and frontal area of the brain are areas with receptors for insulin, meaning that the hippocampus structure is majorly damaged...

ea0086p350 | Neuroendocrinology and Pituitary | SFEBES2022

Central diabetes insipidus associated with Covid-19 infection and vaccination – could this be a ‘common’ phenomenon?

Thrower Sally , Adam Khloud , Evans Alison

Background: Central diabetes insipidus (DI) has now been described in a handful of case reports as a symptom of Covid-19 infection - associated with acute respiratory distress syndrome (ARDS)1 - and as a possible late onset sequela secondary to Covid-19 infection. It has also once been reported following immunization with mRNA Covid-19 vaccination. Our Trust serves a population of 612,000 and we have recently observed two cases of central DI, one post Covid-19 infection and on...

ea0086p351 | Neuroendocrinology and Pituitary | SFEBES2022

Hypophysis associated with Crohn’s disease - Think DI as well as GI in dehydrated thirsty Crohn’s disease patients with rising sodium!

Jamsheed Mohammed , Bujanova Jana

Introduction: Hypophysitis is a rare association of inflammatory bowel disease (IBD) with only few cases reported in the literature. It can present with isolated hormone deficiencies or panhypopituitarism. Patients may also present with symptoms secondary to inflammatory pituitary mass. Management consists of hormone replacement therapy, but high dose steroids, steroid sparing agents like Rituximab or even surgery may be required for mass effect.Case rep...

ea0086p352 | Neuroendocrinology and Pituitary | SFEBES2022

The heart bleeds – complex management of a patient with acromegaly, cardiomyopathy and mechanical mitral valve

Sharma Aditi , Nyunt Sandhi , Narula Kavita , Mitchell Catherine , Mendoza Nigel , Yong Yong , Hatfield Emma , Meeran Karim , Martin Niamh

A 44 year old gentleman presented to his local hospital with a two week history of fevers and rigors. Blood cultures were positive for Streptococcus oralis, and an echocardiogram confirmed new diagnosis of hypertrophic cardiomyopathy (HCM) complicated by mitral valve infective endocarditis (IE). Unfortunately, this required a mechanical mitral valve replacement (MVR) and he started warfarin (INR target 2.5-3.5). During his admission, he reported chronic headaches. An MRI brain...

ea0086p353 | Neuroendocrinology and Pituitary | SFEBES2022

The burden of heatwave-related profound hyponatraemia: Is the climate change making these events more likely?

Mohd Ruslan Aliya , Okosieme Onyebuchi

During the warmest days reported in Wales and the United Kingdom recently, we have seen severe hyponatraemia phenomena in this part of the world. Water intoxication causes acute hyponatraemia when the sodium concentration of the blood falls too low due to prolonged sweating combined with excessive fluid consumption. Although primary polydipsia is found in a broad range of individuals including those with mental disorders, and healthy persons, as well as athletes who run marath...

ea0086p354 | Neuroendocrinology and Pituitary | SFEBES2022

Primary CNS lymphoma presenting with cranial diabetes insipidus – a case series

Madden Doyle Lauren , Cussen Leanne , McDonnell Tara , O'Reilly Michael W , Agha Amar

Primary CNS lymphoma (PCNSL) accounts for 0.85% - 2.0% of primary brain tumours. PCNSL arises in periventricular regions of the corpus callosum, with hypothalamic involvement less commonly. While cases have been reported in the literature, cranial diabetes insipidus (CDI) secondary to PCNSL is a rare phenomenon. We present this case series of three patients from our institution diagnosed with CDI and panhypopituitarism in the context of PCNSL.Cases: 1. 3...

ea0086p355 | Neuroendocrinology and Pituitary | SFEBES2022

An unusual case of (extremely) delayed ACTH deficiency following pituitary gamma-knife radiotherapy

Radia Florika , Ali Tauni Rahat

59-year-old male, with a background of treated acromegaly, presented to endocrine clinic with new onset fatigue. He was diagnosed with acromegally 18 years prior to his presentation, and had a transphenoidal hypophysectomy followed by gamma-knife radiation. Post-surgery he developed partial anterior hypopituatrism (LH and FSH). He currently takes testosterone replacement. He is still receiving medical management with Somatuline. He developed hypothyroidism 16 years following h...