Searchable abstracts of presentations at key conferences in endocrinology
Previous issue | Volume 104 | SFEIES24

Joint Irish-UK Endocrine Meeting 2024

Belfast, Northern Ireland
14 Oct 2024 - 15 Oct 2024

Card image cap

Poster Presentations

Adrenal & Cardiovascular

ea0104p1 | Adrenal & Cardiovascular | SFEIES24

Hypoparathyroidism in aicardi-goutières syndrome (AGS)— a descriptive case report

Al Mohamad Nawal , Hakmi Abdulhafiz

Aicardi-Goutières syndrome (AGS) is a genetically inherited autosomal recessive disorder characterized by progressive encephalopathy, predominant basal ganglia calcifications, and elevated cerebrospinal fluid interferon-alpha (IFN-α) levels. The clinical manifestations often include seizures, cognitive impairment, and generalized dystonia. While the prevalence of AGS remains uncertain, pathogenic variants linked with AGS have been detected in affected individuals fro...

ea0104p2 | Adrenal & Cardiovascular | SFEIES24

Association of the CT genotype of the polymorphic marker rs12979860 of the IL28B gene with autoimmune adrenal insufficiency

Nuralieva Nurana , Yukina Marina , Meremyanina Ekaterina , Troshina Ekaterina , Svitich Oksana

Aim: To identify associations of polymorphisms in TLR9, IL28B, TLR2 with autoimmune adrenal insufficiency (AAI).Methods: In n = 54 patients with AAI (isolated and as part of type 2 autoimmune polyglandular syndrome (APS-2; group 1a)), n = 9 patients with APS-1 (group 1b), n = 32 healthy individuals (group 2) we analyzed polymorphisms in IL28B (rs12979860, rs8099917), TLR9 (rs5743836, rs352140), TL...

ea0104p3 | Adrenal & Cardiovascular | SFEIES24

A rare case of co-existing anti-HMGCR immune-mediated necrotising myopathy and pheochromocytoma

Maher Sean , Longergan Eibhlin , Connolly Sean , Fullam Sarah , Orr Carl , Crowley Rachel

Case History: A 60 year-old male presented to ED with an elevated Creatinine Kinase (CK) of 16,685IU/l (40-320), ALT 788 IU/l (9-59), AST 785 IU/l (11-34) and lower limb fatigue and weakness. There was no upper limb or skin involvement. He had a ST-Elevation Myocardial Infarction in 2022, Coeliac Disease, and Trigger Finger. Statin therapy was stopped, and IV fluids commenced. CK down trended to 11,000IU/l in 24 hours. He was discharged with urgent rheumatology follow-up. 10da...

ea0104p4 | Adrenal & Cardiovascular | SFEIES24

Antihypertensive and comorbid medication patterns in patients referred to a specialist hypertension service: implications for work up and subsequent management

Harikrishnan Shivani , Sathyanarayanan Abilash , Clayton Jenny

Introduction: The antihypertensive (AHT) medication choice, and the use of other drugs that affect the blood pressure (BP) have implications on the work up and management strategy of hypertension referrals.Methods: We collected data from 300 referrals to a specialist hypertension service (sampled from referrals received between March 2023-24).Results: a) 96.7% of the referrals were from primary care, the rest were from emergency ca...

ea0104p5 | Adrenal & Cardiovascular | SFEIES24

Adrenal crisis precipitated by omission of regular intramuscular depo-medrone injections: the importance of counselling for adrenal insufficiency in rheumatology patients on long term exogenous steroids

Austin Isobel , Johnston Philip C.

Background: Prolonged use of exogenous steroids is common for the treatment of many rheumatological conditions, this can result in suppression of the hypothalamic-pituitary-adrenal (HPA) axis. Adrenal insufficiency can lead to life threatening adrenal crisis if undertreated or not recognised.Clinical Case: A 55-year-old woman with a history of sero-negative arthritis had been receiving monthly intramuscular (buttock/hip) injections of 120 mg Depo-medrone...

ea0104p6 | Adrenal & Cardiovascular | SFEIES24

Benefits of medical therapy with alpha-adrenergic inhibition pre-operatively for secretory paragangliomas – more than just blood pressure control

Tufton Nicola , Akker Scott

Many symptoms of phaeochromocytomas and paragangliomas (PPGL) are due to the effects of excess catecholamines. Catecholamines exert their effect on alpha- and beta-adrenergic receptors. Before patients undergo curative surgery, guidelines recommend medical management is commenced to provide cardiovascular stability. This blockade allows restoration of normotension and normal circulating volume (reducing the risks of an intraoperative hypertensive crisis and postoperative hypot...

ea0104p7 | Adrenal & Cardiovascular | SFEIES24

Abstract withdrawn...

ea0104p8 | Adrenal & Cardiovascular | SFEIES24

Multivessel spontaneous coronary artery dissection in a young woman using cabergoline

Byrne Rachel , O'Shea Linda , Shiels Paul , Kumar Rajesh

Introduction: Spontaneous coronary artery dissection (SCAD) is a unique clinical entity gaining rapid recognition as an important cause of acute coronary syndrome (ACS). Cabergoline induced SCAD is exceedingly rare. We present a unique case of a young woman with multivessel SCAD on a background of Cabergoline use. To date, limited literature is available on cabergoline induced SCAD and we describe the first ever reported case in our country.Case report: ...

ea0104p9 | Adrenal & Cardiovascular | SFEIES24

Difference in the relation between circulating free thyroxine (FT4) and thyroid stimulating hormone (TSH) levels for people taking levothyroxine compared with those who are on no thyroid hormone replacement

Heald Adrian , Taylor Peter , Dayan Colin , Chaudhury Nadia , Okosieme Buchi , Lakdasa Premawardhana Lakdasa , Stedman Mike

Introduction: There continues to be much discussion around optimization of thyroid hormone status in hypothyroid individuals. We looked the way that FT4/TSH relate to each other in people who underwent a check of thyroid function (TFT) split between those on levothyroxine replacement (monitoring-test) and those who underwent TFT check as a screening test for thyroid hormone imbalance not-on-levothyroxine.Methods: TFT test (FT4/TSH) results were taken fro...

ea0104p10 | Adrenal & Cardiovascular | SFEIES24

A rare case of primary adrenal malignant melanoma masquerading as metastatic adrenocortical cancer

Venkatesh Spurthi , Levy Miles J. , Gohil Shailesh , Bhardwaj Neil , Bremner Emma , Dormer John , Shah Vikas , Reddy Narendra L.

Introduction: Melanoma is predominantly a skin malignancy, originating from melanocytes. We present a rare case of metastatic primary adrenal melanoma (PAM) mimicking adrenal cortical carcinoma (ACC).Case report: A 36-year-old male presented with right flank pain, vomiting, pyrexia & 15kg weight loss. CT revealed 6cm adrenal mass; initially treated as an abscess. Despite normal adrenal screening biochemistry & prolonged antibiotics, the mass grew...

ea0104p11 | Adrenal & Cardiovascular | SFEIES24

Salivary cortisol vs serum cortisol in the overnight dexamethasone suppression test: results of a service evaluation at one centre

Heald Adrian , Majeed Waseem , Taylor Peter , Michaelidou Maria , Syed Akheel , Keevil Brian

Introduction: Saliva hormone measurements are increasingly being applied in every day clinical practice. In relation to salivary cortisol/cortisone measurement there is a particular advantage, with minimal chance of cross reaction with prescribed glucocorticoids. We here evaluated the utility of these measurements in patients undergoing an overnight (1 mg) dexamethasone suppression test (ONDST).Methods: A service evaluation of salivary cortisol/cortisone...

ea0104p12 | Adrenal & Cardiovascular | SFEIES24

Exploring patient and caregivers’ perceptions and experiences of administering hydrocortisone injection during an adrenal crisis: a mixed-methods cross-sectional study

Llahana Sofia , Anthony Julia , Ross Richard

Background: Patients with AI and their caregivers face significant challenges during adrenal crises, particularly with hydrocortisone injections often requiring up to 20 steps to administer, which impedes effective self-treatment.Aim: To explore the perceptions and experiences of patients with AI and their caregivers regarding the administration of hydrocortisone injections during an adrenal crisis.Methods: Participants were recrui...

ea0104p13 | Adrenal & Cardiovascular | SFEIES24

Conn’s syndrome, where is the lesion?

McManaman Conor , Taylor Amybel , Emmanuel Julian

Primary Aldosteronism (PA) can be due to a variety of underlying pathologies, predominantly aldosterone-producing adenomas and adrenal hyperplasia. PA is one of the leading causes of secondary hypertension in young patients. We describe the case of a young male presenting with a stroke in 2012, six years later he had a second ischaemic event and was noted to have treatment resistant hypertension. This constellation of symptoms prompted an investigation revealing hypertension, ...

ea0104p14 | Adrenal & Cardiovascular | SFEIES24

Adrenal cushing syndrome presenting as type 2 diabetes

Yusuf Dalhatu , Craig Stephen , Lambert Paul

Background: Cushing syndrome is caused by chronic, autonomous excess cortisol and causes a wide range of clinical manifestations. Impaired glucose metabolism which often leads to diabetes is a common complication of long-term exposure to both exogenous and endogenous glucocorticoid and plays a vital role in contributing to morbidity and mortality in patients with Cushing syndrome. The prevalence of diabetes in Cushing syndrome varies between 20 and 50% and the overall prevalen...

ea0104p15 | Adrenal & Cardiovascular | SFEIES24

Histopathological reporting of pheochromocytomas and paragangliomas (PPGLs)

Burke Kevin , Ipadeola Olubunmi , Almezen May , Noctor Eoin , Bin Mahfooz Mohammed , Marie Hannon Anne , Melvin Audrey

PPGL’s are tumours arising from adrenomedullary and extra-adrenal chromaffin cells. The Royal College of Pathologists (RCPath) has issued updated guidance on the minimum dataset requirements in the histopathological reporting of PPGLs. The datasets enable pathologists to grade and stage cancers in a consistent manner and provide prognostic information, to facilitate the highest standard of care for patients. This retrospective analysis was conducted to assess if PPGL hist...

ea0104p16 | Adrenal & Cardiovascular | SFEIES24

A forgotten relation between adrenal insufficiency and auricular petrification

Ahsan Masato , Levy Miles , Reddy Narendra , Gohil Shailesh

Background: Calcification or ossification of the auricular cartilage, known as "petrified ears," is a rare condition typically linked to local trauma, frostbite, or inflammation. Endocrinopathies, especially adrenal insufficiency, has been historically linked with this condition. There are several reports of its association with different causes of primary adrenal insufficiency but only a very few reported cases of secondary adrenal insufficiency leading to bilateral auricular...

ea0104p17 | Adrenal & Cardiovascular | SFEIES24

WES as a tool for differential diagnosis of adrenal insufficiency in sudanese children

Smith Chris , Abdullah Mohamed , Hassan Samar , Fauzi Luqman , Qamar Younus , Hall Charlotte , Maitra Saptarshi , Maharaj Avinaash , Marroquin Ramirez Lucia , Read Jordan , Chan Li , Musa Salwa , Metherell Louise

Studies of adrenal insufficiency (AI) in African children are rare and diagnosis is challenging, especially in resource limited settings where biochemical and genetic testing are restricted. We describe the genetic characterisation of a cohort of Sudanese children, identifying founder effects and commonly mutated genes that will improve their treatment, expand our knowledge of AI, and expedite diagnosis of future patients. 48 patients from 43 families (31M:17F) with presentati...

ea0104p18 | Adrenal & Cardiovascular | SFEIES24

Adrenal insufficiency associated with mutations in haem biosynthesis genes, is it a coincidence?

Al-Salihi Ahmed , Smith Chris , Jackson Adam , Janecke Andreas , Steichen Elisabeth , Darby Denise , Griffin Liezel , Banka Siddharth , Elsayed Solaf , Talbi Neila , Gouya Laurent , Delemer Brigitte , Chan Li , Metherell Louise

Primary adrenal insufficiency (PAI) is associated with mutations in more than 25 genes, in our cohort, most commonly the melanocortin receptor gene (MC2R), its accessory protein (MRAP), steroidogenic enzymes (STAR and CYP11A1), and a gene involved in mitochondrial anti-oxidant defence (NNT). While mutations in haem biosynthesis genes have only ever been implicated as pathogenic in a group of diseases known as porphyria, over the yea...

ea0104p19 | Adrenal & Cardiovascular | SFEIES24

Pheochromocytoma presenting as cardiac emergencies

Mohamed Farouk , Krishnan Amutha

Case 1: A 65 year-old lady presented to ED with chest pain and collapse. Her PMH includes hypothyroidism and gastritis. Results and management: Her ECG was normal. Her troponin levels were raised at 48 and 70.6. CTPA which was requested as her D-dimer was high (1034), showed no PE but showed hypodense lesions in liver. In view of this, CT TAP was done which showed benign liver cysts, and a 2.6 cm adrenal mass. She was treated for ACS. Her ECHO and Angiog...

ea0104p20 | Adrenal & Cardiovascular | SFEIES24

Primary aldosteronism in a patient with cushing’s disease in remission

Tomkins Maria , Mc Donald Darran , Lee Jack , Martin-Grace Julie , Carthy Claire , Finnegan John , Mulholland Douglas , Dugal Neal , W. O'Reilly Michael , Sherlock Mark

A 47-year-old man attending with a history of Cushing’s disease in remission following transsphenoidal surgery in 2013 continued to experience resistant hypertension which warranted further investigation. Postoperatively he was prescribed hydrocortisone 10 mg twice daily and desmotab 0.2 mg nocte for ACTH deficiency and diabetes insipidus. Over the course of six years antihypertensive therapy escalated until he required five agents – ramipril 10 mg, amlodipine 10 mg,...

ea0104p21 | Adrenal & Cardiovascular | SFEIES24

Impaired 11β-hydroxysteroid dehydrogenase type 2 activity in chronic kidney disease disrupts 11-oxygenated androgen biosynthesis

Tomkins Maria , McDonnell Tara , Cussen Leanne , Sagmeister Michael S. , Oestlund Imken , Shaheen Fozia , Harper Lorraine , Hardy Rowan S. , Taylor Angela E. , Gilligan Lorna C. , Arlt Wiebke , McIlroy Marie , de Freitas Declan , Conlon Peter , Magee Colm , Denton Mark , O'Seaghdha Conall , Snoep Jacky L. , Storbeck Karl-Heinz , Sherlock Mark , O'Reilly Michael W.

In vitro data highlight a potential role for 11β-hydroxysteroid dehydrogenase type 2 (HSD11B2) in 11-oxygenated androgen biosynthesis, converting 11β-hydroxyandrostenedione (11OHA4) to 11-ketoandrostenedione (11KA4), the direct precursor of the potent androgen 11-ketotestosterone(11KT). As the kidney is the major site of HSD11B2 expression, we hypothesized that patients with chronic kidney disease (CKD) would have reduced 11-oxygenated androgen biosynthesis ...

ea0104p22 | Adrenal & Cardiovascular | SFEIES24

Functional imaging in primary aldosteronism: a useful tool in a complex case

Darrat Milad , Cvasciuc Titus , Graham Una , Hunter Steven , McFarlane James , Gurnell Mark , Mullan Karen

A 39 year-old man was referred with resistant hypertension from the nephrology service. Diagnosis was at 26 years and associated with hypokalaemia, left ventricular hypertrophy and proteinuria. Initial results (on amiloride) were: Aldosterone (A) 1900 pmol/l, direct renin (R) 10.2mU/mL and Aldosterone:Renin Ratio (ARR) 186. Saline suppression testing off interfering medications confirmed primary aldosteronism (PA): Aldosterone 1050 pmol/l, Renin 4.1uIU/mL and ARR 256 at four h...

ea0104p23 | Adrenal & Cardiovascular | SFEIES24

Management and outcomes of patients treated with mitotane for adrenocortical carcinoma in a tertiary adrenal tumour centre in Ireland

Tomkins Maria , Al-Busaidy Merah , Mc Donald Darran , Martin-Grace Julie , Carthy Claire , Agha Amar , Hill Arnold , Dugal Neal , Robb William , O'Reilly Michael W. , Sherlock Mark

Adrenocortical carcinoma (ACC) is a rare aggressive tumour with median overall survival of 3-4years. Mitotane may be recommended for use in ACC in an adjuvant or palliative setting. It requires close clinical surveillance and therapeutic drug monitoring due to adverse effects and toxicity potential. This audit reviewed the management practices in patients with ACC prescribed mitotane therapy from 2010 to 2023 in Beaumont Hospital compared to the 2018 ESE/ENSAT clinical practic...

ea0104p24 | Adrenal & Cardiovascular | SFEIES24

The aldosterone renin ratio – high rates of positive tests, low rates of onward referral; a single centre quality improvement project

Raheel Sajjad M. , Hoashi Shu , Lee Graham R. , Crowley Vivion , Healy Ultan

The Endocrine Society Guidelines 2016 recommend the Aldosterone Renin Ratio (ARR) to screen for Primary Hyperaldosteronism (PHA), yet we perceive low rates of referral to our service for such patients. Here we report a retrospective audit of ARR measurements requested through Regional Hospital Mullingar 01/01/2023 – 31/12/2023. ARR results were obtained directly from the referral laboratory. An assay specific ARR threshold >25 (ARR+) indicates possible PHA. We reviewe...

ea0104p25 | Adrenal & Cardiovascular | SFEIES24

Comparison of a morning serum cortisol concentration against a morning salivary cortisone concentration to predict the outcome of a short synacthen test

Martin-Grace Julie , Lawless Sarah , Tomkins Maria , McDonnell Tara , Cussen Leanne , Hazel Karl , Heverin Karen , Srinivasan Shari , Keevil Brian , O'Toole Aoibhlinn , Costello Richard , O'Reilly Michael W. , Sherlock Mark

The short synacthen test (SST) is a well-established method to assess adrenal function. Recent data has suggested a waking salivary cortisone may be a more convenient alternative to serum cortisol testing to predict SST outcome. This study compares the performance of a 9am serum cortisol sample to a simultaneous 9am salivary cortisone sample to predict SST outcome, to establish which method results in a greater reduction in SST requirements. We recruited 122 participants to un...

ea0104p26 | Adrenal & Cardiovascular | SFEIES24

Case report: congenital adrenal hyperplasia or adrenal hypoplasia congenita

Green Deirdre , O'Halloran Domhnall

Adrenal hypoplasia congenita (AHC) is a rare and potentially life-threatening disorder of adrenal gland development, resulting from deletion or mutation of the DAX-1 gene. DAX-1 is located on the short arm of the X chromosome, and mutations result in X-linked primary adrenal hypoplasia, hypogonadotropic hypogonadism, and azoospermia in men. During the neonatal period, male patients present with signs and symptoms often indistinguishable from those seen in salt-losing 21-hydrox...

ea0104p27 | Adrenal & Cardiovascular | SFEIES24

Diagnostic and therapeutic challenges of metastatic pheochromocytoma; case series

Apsara Dilrukshi Mathara Diddhenipothage Shani , Sabharwal Nikant , Andrade Gerard , Jafar-Mohammadi Bahram , May Christine JH.

Introduction: We present cases of metastatic pheochromocytoma highlighting diagnostic, management, and therapeutic challenges. Case-1: 69 Female, presented with breathlessness, palpitations, and sweating of 4 months. Panic attacks of 10 years. Imaging confirmed left-sided pheochromocytoma, bone, liver, and pulmonary metastases. Plasma metadrenaline (MT) 4471 pmol/l (0-510), normetadrenaline (NMT) >25000 pmol/l (0-1180) LVEF 30%, global LV hypokinesia...

ea0104p28 | Adrenal & Cardiovascular | SFEIES24

Assessing the adverse health impacts of glucocorticoid therapy in obstructive lung disease (AHEIGHT Study)

Martin-Grace Julie , Lawless Sarah , Tomkins Maria , Brennan Vincent , Heverin Karen , Srinivasan Shari , Long Deirdre , Costello Richard , O'Reilly Michael W. , Sherlock Mark

Background: Oral and inhaled glucocorticoids are commonly used medications in the treatment of obstructive lung disease, and both are associated with glucocorticoid-induced adrenal insufficiency (GIAI) (1). However, the prevalence and clinical consequences of GIAI in this population are incompletely understood.Aims/Methods: We aimed to assess the prevalence of undiagnosed GIAI in an unselected cohort of patients with asthma attending secondary care, and ...

ea0104p29 | Adrenal & Cardiovascular | SFEIES24

Implementing the study into the health status in adults with CAH in the UK and ireland - CAHASE2

Investigators CAHASE2 , Society for Endocrinology

Congenital adrenal hyperplasia (CAH) occurs with an incidence of about 1 in 15,000. Several studies highlighted the suboptimal health status and care provision in adults with CAH that were associated with significant co-morbidities in relatively young adults. In 2023, we implemented CaHASE2 to develop a strategy for prospective collection of longitudinal health data of patients with CAH. Our recent CAH service evaluation suggested significant differences in the approach to CAH...

ea0104p30 | Adrenal & Cardiovascular | SFEIES24

Audit of short synacthen® test results in a university teaching hospital

McGee Elizabeth , Crowley Niamh , O'Dwyer Olivia , Cullen Rachel , McGing Peader , McQuaid Siobhan

Introduction: Short synacthen® test (SST) is widely used to assess adrenal function. Controversy remains concerning sample timing and diagnostic cut-offs.Methods: A retrospective analysis of SST results over 48-month period (1/1/2020 - 31/12/2023) was undertaken. Our protocol involves sampling cortisol at times 0, 30 and 60 minutes post Synacthen® 250 mg IM. Normal SST response was peak cortisol (assayed using ...

ea0104p31 | Adrenal & Cardiovascular | SFEIES24

A case of biochemically silent pheochromocytoma masquerading as adrenal incidentaloma

Nasar Khan Aida , Khan Farooq , Ryan James

Introduction: Pheochromocytomas are rare catecholamine-secreting tumors, primarily arising from the adrenal medulla, typically presenting with hypertension, palpitations, and headaches. Diagnosis involves hormonal evaluation and CT imaging with a washout of <40-60%. Recent studies show exceptions, with some tumours mimicking non-functional adenomas, displaying >60% washout. We present a case exemplifying this, where a symptomatic patient had normal initial biochemical ...

ea0104p32 | Adrenal & Cardiovascular | SFEIES24

Hyperthermia-induced cell death in adrenocortical carcinoma: efficacy and mechanisms beyond caspase 3 apoptosis

Mullen Nathan , Donlon Padraig T. , Feely Sarah , Sorushanova Anna , Challapalli Ritihaas , Warde Kate M. , Hong Cong , Prakash Punit , O'Halloran Martin , Conall Dennedy Michael

Adrenocortical carcinoma (ACC) is a rare, aggressive cancer with notable resistance to conventional therapies. Despite advancements in medical research, understanding the mechanisms behind ACC’s resilience and exploring novel therapeutic strategies remain underdeveloped. Hyperthermia, the exposure of body tissue to high temperatures, is a potential treatment. However, the fundamental principles of how hyperthermia induces cell death in ACC are not well understood. This st...

ea0104p33 | Adrenal & Cardiovascular | SFEIES24

A case of secondary adrenal insufficiency related to long term steroids

Kossinnage Chethana , Rafiuldeen Raiyees , Fernando Devaka

Background: Topical corticosteroids are frequently prescribed by dermatologists and primary care physicians. They are the most commonly prescribed medications in dermatology practice due to their anti-inflammatory and immunosuppressive properties. If used within a therapeutic window they are safe and effective, and their adverse effects are rare. Prolonged use even with topical agents can result in both local and systemic side effects. However, patients are often unaware of th...

ea0104p34 | Adrenal & Cardiovascular | SFEIES24

An evaluation of the current protocol for short synacthen tests in a single hospital centre

Singh Mahendra , Nelson Edel , Marie Hannon Anne , Melvin Audrey , Noctor Eoin , Bin Mahfooz Mohammed , Rasheed Erum

The short synacthen test (SST) is the most commonly performed investigation to assess adrenal function. We retrospectively audited the SSTs performed by the endocrine department in University Hospital Limerick between 2022 and 2024. The SST was performed as per our hospital protocol. A post-adrenocorticotropic hormone (ACTH) cortisol response of 450 nmol/l (using Roche Elecsys Cortisol III immunoassay) at any time point was considered adequate to rule out adrenal insufficiency...

ea0104p35 | Adrenal & Cardiovascular | SFEIES24

An audit of sick-day rule management of adrenal insufficiency in a single centre

Yi Joyce Tan Lok , Veerasamy Kevin , Morgan Elliot , Bin Mahfooz Mohammed , Noctor Eoin , Melvin Audrey , Marie Hannon Anne

Patients with adrenal insufficiency should be prescribed stress dose steroids in acute settings to avoid adrenal crisis. Adrenal crisis is life-threatening if not recognized and if treatment is delayed. This audit aimed to identify the current practice of sick-day rule management in University Hospital Limerick of admitted patients with adrenal insufficiency. A cross-sectional analysis was conducted on inpatients referred for endocrinology consultation for adrenal insufficienc...

ea0104p36 | Adrenal & Cardiovascular | SFEIES24

Uptake of K20-coated iron oxide nanoparticles by adrenocortical carcinoma cells

Surya Challapalli Ritihaas , Sorushanova Anna , Hong Cong , Mullen Nathan , Feely Sarah , Covarrubias-Zambrano Obdulia , Covarrubias Jose , Varghese Sunitha , Hantel Constanza , Owens Peter , O'Halloran Martin , Prakash Punit , Bossmann Stefan , Conall Dennedy Michael

Adrenocortical carcinoma (ACC) is a rare cancer with a poor prognosis, typically resulting in a survival rate of up to 24 months. Treatment options include surgery, chemotherapy, and radiation, but the high recurrence rate underscores the need for new therapies. Magnetic iron oxide nanoparticles (IONP) are emerging as promising tools for cancer treatment due to their customizable size, shape, and surface properties for targeted cellular uptake. Our initial study investigated t...

ea0104p37 | Adrenal & Cardiovascular | SFEIES24

11β-hydroxysteroid dehydrogenase type 1 inhibition unmasks multiple pathways that may mitigate the adverse effects of prescribed prednisolone

Pofi Riccardo , Coll Sergi , Othonos Nantia , Miller Hamish , Potter Tom , Jane Escott K. , Whittaker Andrew , Monfort Nuria , Ventura Rosa , Tomlinson Jeremy W.

Background: Prednisolone is the most prescribed exogenous glucocorticoid (GC) and its use is frequently associated with iatrogenic Cushing’s Syndrome. Once administered, prednisolone is converted to inactive prednisone by renal 11β-hydroxysteroid dehydrogenase type 2(11β-HSD2) and reactivated by 11β-HSD1. We have shown previously that 11β-HSD1 inhibition (with the selective 11β-HSD1 inhibitor, AZD4017) mitigates prednisolone-induced adverse effect...

ea0104p38 | Adrenal & Cardiovascular | SFEIES24

Peri-operative challenges in adrenalectomy for pheochromocytoma with severe catecholamine induced cardiomyopathy

Woodley Charlotte , Murthy Buddhavarapu , Rao Ranganatha , Baskar Varadrajan

Introduction: Pheochromocytoma is a rare catecholamine-secreting tumour that commonly arises from the adrenal medulla. In addition to the episodic cardiovascular complications leading to severe hemodynamic disturbances perioperatively, it has been increasingly recognised that catecholamine-related cardiomyopathy is a life-threatening condition. Our case highlights the complexities and risks involved in the perioperative management of adrenalectomy.Case R...

ea0104p39 | Adrenal & Cardiovascular | SFEIES24

Diuretic induced flaccid paralysis as first presentations of primary aldosteronism

O'Murchadha Liam , Brennan Ian M. , Donohoe Claire L. , Abdelfadil Sabah , Crowley Vivion , Pazderska Agnieszka

Introduction: Hypokalaemia related flaccid paralysis is a rare condition of transient, severe muscle weakness caused by temporary muscle excitability loss due to low plasma potassium concentrations. We present two patients who were diagnosed with primary aldosteronism after developing profound muscle weakness, following initiation of diuretics.Case 1: A 35-year-old European male presented to the Emergency Department with severe limb pains, weakness and e...

ea0104p40 | Adrenal & Cardiovascular | SFEIES24

Things that go bump in the night: phaeochromocytoma a cause of nocturnal headaches

Hussain Aliya , Cairns Ross , Clark Louise

Phaeochromocytoma is rare and can be challenging to diagnose. The classic triad of paroxysmal headache, palpitations and pallor is not seen in most cases and the presentation can be more unusual. We describe a case of chronic nocturnal headaches caused by Phaeochromocytoma. A 58-year-old man with a PMHx of Essential Hypertension and Diabetes Mellitus Type 2 presented overnight to the Emergency Department with a sudden and severe “thunderclap headache”. The patient described a ...