Endocrine Abstracts

Introduction: We present two pregnant women who were referred to obstetric endocrinology service with polyuria and polydipsia. They were investigated and treated for diabetes insipidus (DI). In both cases, the underlying pathophysiology was ADH insufficiency secondary to autoimmune lymphocytic hypophysitis. There are currently no consensus guidelines on the diagnosis of DI during pregnancy. These cases highlight best practice and endorse MDT management of chronic hypopituitari...

Introduction: Association between lymphoma and pituitary dysfunction is well documented, though most commonly through mechanism of infiltrative pituitary metastasis, or primary lymphoma of the pituitary, rather than autoimmune lymphocytic hypophysitis. Here we present a highly unusual case whereby investigation into the cause of Diabetes Insipidus with radiological features of lymphocytic hypophysitis, led to diagnosis and cure of Diffuse Large B-cell lymphoma (DLBCL). Diabete...

Background: Nephrogenic diabetes insipidus (DI) is characterized by polyuria with dilute urine due to the inability of the principal cells of the renal collecting ducts to respond to antidiuretic hormone and concentrate urine. It can be drug-induced and several chemotherapeutic agents, including the platinum derivative cisplatin and the antimetabolite pemetrexed, have been reported to cause nephrogenic DI, presumably via tubular damage.Case presentation:...

Background: Silent corticotroph adenomas (SCAs) are considered to be clinically silent and non-secreting but exhibit positive adrenocorticotropic hormone (ACTH) immunostaining. Whether, SCAs behave more aggressively than other non-functioning adenomas, remains controversial. We characterized our tertiary centre cohort of SCA patients, compared them to gonadotroph adenomas (GAs) and assessed for features predictive of recurrence.Objective: To compare char...

Background: Traditional method in Sheffield involved preoperative admission and use of an intensive regimen. The pandemic led to the development and implementation of an outpatient-based protocol (SPROG - ‘Sheffield Peri-operative Rapid Optimisation in Graves’ disease (GD)’) for patients’ intolerant to thionamides and/or with uncontrolled disease requiring thyroidectomy. Control was achieved using sequential addition and dose-escalation of drugs such as Lug...

We report a 56-year-old male patient who presented in September 2006 with a left eye inferior temporal visual field defect and a left relative afferent pupillary defect. Imaging demonstrated a 4 cm giant cavernous left carotid aneurysm causing pressure symptoms resulting in the above visual failure.The patient had internal carotid coil embolisation of the left internal carotid artery.The patient re-presented in February 2008 with e...

Introduction: The thyroxine absorption test (TAT) is well established to investigate persistently raised TSH in patients on L-thyroxine. We review our experience with this test.Method: Blood was taken for baseline FT4, FT3, TSH measurements and malabsorption screen. A week’s supply of L-thyroxine (1.6 mcg/kg×7) was administered orally under direct supervision and FT4 and TSH measured 2 h later. Patients continued o...

Aim: To investigate the relationship between baseline and stimulated cortisol responses in relation to the habitual time of rising and time of test.Method: The self-reported habitual rising time and time of cortisol testing were recorded in 63 consecutive patients (47F, 17M, age 18–94) undergoing standard stimulation testing with tetracosactide (SynActhen) 250 μg i.v. In total, 75 tests were analysed. A normal response was defined as a 30 min p...

Aims/objectives: The aim of this retrospective audit on MANAGEMENT OF ACUTE CHARCOT ARTHROPATHY was to assess the current practice at King’s Mill hospital against the latest National institute of clinical excellence guidelines.Methods: A retrospective audit of 22 patients with diabetes presented with acute Charcot neuro-arthropathy, between January 2016 and August 2018 to the specialist diabetes foot team at KMH. The data was collected from the hosp...