Endocrine Abstracts

I am committed to undergraduate and postgraduate education. As Endocrinology course lead, Imperial College Medical School, I have designed a course to consolidate key principles of Endocrine pathology and physiology. Clinical reasoning is a cornerstone of clinical practice and a key learning requirement in undergraduate medical education. I have focused on developing clinical reasoning skills throughout the Endocrinology course using interactive clinical cases. The students ha...

As a clinical trainee, you may be presented with teaching opportunities, but these are often opportunistic. Clinical training rarely provides sufficient flexibility to commit to developing substantial teaching roles. As you progress towards CCT and into a consultant post, you may be interested in developing a clinical teaching career but feel unclear about how to navigate this. Many skills that you h...

‘Clinicians who have never missed the diagnosis of Cushing's syndrome or have never been fooled by attempting to establish its cause should refer their patients with suspected hypercortisolism to someone who has.’ This quote, by Professor James Findling, an expert in Cushing’s syndrome, is a reminder of the difficulties in diagnosing Cushing’s syndrome. These difficulties in part reflect the increasing incidence of obesity, hypertension and type 2 diabetes....

‘Clinicians who have never missed the diagnosis of Cushing's syndrome or have never been fooled by attempting to establish its cause should refer their patients with suspected hypercortisolism to someone who has.’ This quote, by Professor James Findling, an expert in Cushing’s syndrome, is a reminder of the difficulties in diagnosing Cushing’s syndrome. These difficulties in part reflect the increasing incidence of obesity, hypertension and type 2 diabetes....

I am a Consultant Endocrinologist and Reader in Endocrinology. I have a strong interest in undergraduate education and hold various educational roles at Imperial College London, including Head of Year 1, BSc in Biomedical Sciences. This is a new degree course aimed at students who want careers as biomedical researchers, tackling important human diseases. Hence, early development of laboratory skills is the backbone of this course and we have worked hard to develop new approach...

Background: There is increasing evidence that dopamine agonists used to treat hyperprolactinaemia may cause psychiatric side effects. Male patients have been identified to be at increased risk. This study aimed to establish the incidence of cabergoline-induced psychiatric side effects, potential risk factors for their development and to determine the prevalence of counselling and monitoring for these side effects.Methods:</strong...

Establishing failure of trans-sphenoidal surgery (TSS) to cure Cushing’s disease in the immediate post-operative period is essential for early surgical re-exploration. However, there is no consensus regarding the definition of apparent cure. We studied whether the dexamethasone-suppressed corticotrophin-releasing hormone test (LDDST-CRH test) immediately following TSS could accurately identify those with Cushing’s disease requiring further definitive treatment.<p...

Introduction: Thyrotroph pituitary hyperplasia in context of severe primary hypothyroidism is rare and usually occurs due to loss of thyroxine feedback inhibition and overproduction of thyrotropin-releasing hormone, leading to pituitary gland enlargement. Pituitary hyperplasia caused by primary hypothyroidism responds well to thyroid hormone replacement therapy and rarely requires surgical intervention. Case presentation: A 42-year-old female with backgr...

Background: Immune checkpoint inhibitors (ICIs) including programmed-death cell-1 (PD-1), programmed death-ligand 1 (PD-L1) and cytotoxic T-lymphocyte antigen-4 (CTLA-4) re-activate T lymphocytes and promote cancer cell death. Immune-related adverse events (irAEs) are common in cancer patients receiving ICIs. Endocrine irAEs include primary thyroid dysfunction, hypophysitis, type 1 diabetes mellitus (T1DM) and primary adrenal insufficiency. These endocrinopathies may require a...

Case: A 46-year-old woman was initially investigated for right sided intermittent headaches for one year. Her MRI head revealed a pituitary adenoma. She had no history of vomiting with the headache episodes and had no history of visual acuity or field defect. She had amenorrhoea for the past 10 months. Prior to this, she had regular periods following her menarche at the age of 12 years. She admitted to easy bruising but had no hirsutism or acne. She did not report any weight g...