Endocrine Abstracts

Composite pheochromocytomas (CP) are rare and constitute 3% of pheochromocytomas. So far, less than 100 cases were described in the literature. We present a case of 60 years old man. He was admitted to ER department due to severe bone pain around chest, ribs and vertebra. CT scan showed expansive, 100x87 mm, non-homogenic left adrenal gland tumour as well as metastatic bone lesions. The 24-hour urinary fractionated metanephrines were significantly elevated - 86195 ug/24h (norm...

Introduction: Bile acid malabsorption (BAM) may be a contributing factor causing diarrhoea in patients with NETs, particularly among those who have undergone previous surgical resection of the terminal ileum and/or right colon or cholecystectomy (Naraev et al 2019). Aim(s): To identify the prevalence of bile acid malabsorption in neuroendocrine tumour patients (NET) at the Queen Elizabeth Hospital Birmingham (QEHB). Materi...

Background: The Birmingham Neuroendocrine Tumour (NET) service has a full time dedicated NET Dietitian for outpatient and inpatient care since August 2020. An anonymised survey of patient experience was performed to identify ways in which we can improve the service for patients. 87 potential patients were identified. 8 had passed away. 79 questionnaires were sent out. 38 were returned via a self-addressed envelope.Results: • 53% of patients were fir...

Introduction: Liver Steatosis (LS) can be one of the metabolic complications of Cushing Syndrome (CS). The data on the impact of cortisol on liver function are very limited, according to one study the prevalence of LS in CS is 20%. However, the frequency seems to be much higher. Hepatic Steatosis Index (HSI) predicts LS based on ALT, AST, BMI, sex and co-existence of diabetes mellitus/impaired glucose intolerance. It can identify candidates for further liver examinations.<...

Cushing Syndrome (CS) is associated with a 18-fold higher risk of venous thromboembolism (VTE) when compared to the general population with the similar demographic characteristics. Despite numerous studies on hypercoagulability in CS, the unequivocal recommendations regarding timing and dosing of thromboprophylaxis in hypercortisolism are still lacking. We present a case series of patients with CS and VTE, hospitalized in the Endocrinology Department of University Hospital in ...

Introduction: Liver Steatosis(LS) can be one of the metabolic complications of Cushing Syndrome(CS). The data on the impact of cortisol on liver function are very limited, and there is only one study reporting a prevalence of LS of roughly 20%. Hepatic Steatosis Index (HSI) predicts LS based on ALT, AST, BMI, sex and co-existence of diabetes mellitus/impaired glucose intolerance.Objectives: To evaluate the prevalence of LS in patients with CS at the time...

A case presents a 35 year old woman with a history of Cushing Disease (CD) diagnosed in 2014, who developed multiple complications of long lasting hypercortisolemia- obesity (BMI 55), poorly controlled diabetes mellitus (DM), heart failure, hypertension, hypercholesterolemia, mental disturbances and significant hepatic impairment. She underwent a non-radical pituitary adenoma removal in 2014 with subsequent radiotherapy in 2018. Choice of pharmacological treatment was challeng...

Introduction: According to the literature, the CRH test has the highest specificity in excluding ECS (ACTH 93.9%, cortisol 89.4%). A combination of the high dose dexamethasone test (HDDST) and CRH/desmopressin test (CRH/desmopressinT) is used to increase the discriminatory capacity in ACTH-dependent CS.Objectives: This study aims to investigate the response to dynamic tests in ECS patients.Methods: 35 consecutive ECS patients were ...

Aims: Low circulating testosterone levels are associated with increased cardiovascular risk and there is evidence that androgens inhibit arterial lesion formation. This investigation addressed the hypothesis that androgens directly inhibit neointimal lesion formation by stimulation of vascular androgen receptor.Methods and results: Mice were generated with selective deletion of androgen receptor from vascular (endothelial or smooth muscle) cells. Castrat...

Osilodrostat as an inhibitor of adrenal 11B-hydroxylas, is an effective medication used in the management of endogenous hypercortisolism. There are limited data regarding usage of osilodrostat in ectopic Cushing Syndrome (CS). Surgery is usually the first line treatment in ectopic CS, however the source of ectopic hormonal production often remains undiscovered for a long period of time. Meanwhile dangerous state of severe hypercortisolism needs to be managed pharmacologically ...