Endocrine Abstracts

Background: Recent NICE guidance recommends radioactive iodine as the first line treatment for relapsed thyrotoxicosis as it reportedly produces better control than long-term anti-thyroid drugs (ATDs).However, almost all studies of long-term ATDs relapse occurs after discontinuation of a medication. We present a retrospective analysis of efficacy of ATDs. Methods: Data of all patients with hyperthyroidism, attending Endocrinology clinic at Morriston Hosp...

Aims: Within Imperial College Healthcare Trust, St Mary’s Hospital has a large one-stop shop thyroid service. On average, 700 encounters have been recorded per annum in the St Mary’s thyroid nurse-led service since its inception in June 2017. We aimed to critically evaluate the role of the specialist nurse within safe and robust monitoring clinical parameters, to determine the conditions managed in the nurse-led service and assess attendance rate.<p class="abstex...

Introduction: Autoimmune thyrotoxicosis (AT) affects 2-5% of the Western population. Despite current NICE guidelines recommending radioiodine as first-line treatment for AT, practical considerations such as licensing often prevent this. Typically, anti-thyroid medication (carbimazole or propylthiouracil) is initially offered. Patients are usually counselled that the remission rate following a 12-18 month course of anti-thyroid medication is approximately 50%.<p class="abst...

Background: Primary aldosteronism (PA) is an important, potentially curable, cause of hypertension. Distinguishing unilateral and bilateral causes is a critical step in determining who should be considered for adrenalectomy. Adrenal vein sampling (AVS) remains the gold standard for lateralisation. However, AVS is technically challenging with limited availability. To address this, we have introduced molecular imaging using PET/CT with the radiotracer [11C]Metomidate ...

Short synacthen test (SST) is the most widely used dynamic test of hypothalamic-pituitary-adrenal (HPA) axis function. It’s simple to conduct but requires nursing time and is relatively costly given 15-fold price increase in synacthen since 2015. We audited our SST use with the aim of reviewing clinical indications for testing and identifying useful predictors of test outcome. Baseline referral, clinical and biochemical data were retrospectively collected for individuals ...

Adrenocortical carcinoma (ACC) is an aggressive malignancy with limited treatment options. We identified polo-like kinase 1 (PLK1) as one of the most overexpressed genes and potential drug target in ACC. PLK1 inhibitors (PLK1i) are under evaluation in clinical trials for other malignancies, being more effective in TP53-mutated tumours. Here we test PLK1i efficacy in four ACC cell lines with different genetic background. Efficacy of three PLK1i (i.e. Volaserti...

Control mechanisms of adrenocorticotrophic hormone (ACTH) and cortisol (CORT) secretion and metabolism during acute systemic inflammation (e.g. major surgery) have never been clearly elucidated. We sampled blood every 10 minutes for 12 h during and after coronary artery bypass grafting (CABG) in 10 patients to create profiles of ACTH, CORT and inflammatory mediators and compared these to healthy controls. Patients’ ACTH and CORT responses were classified into one of three...

Background: Growth hormone (GH) and Insulin like growth factor 1 (IGF-1) discordance in patients with acromegaly is a well-recognised phenomenon. It is unclear whether this is associated with increased mortality and morbidity compared to patients with concordant normal results.Methodology: A retrospective study was conducted on the United Kingdom Acromegaly Registry (UKAR). A comparison of mortality and morbidity was performed among four groups categoris...

Aims: Women with gestational diabetes (GDM) who deliver large-for-gestational age (LGA) infants have subtle (1-1.5mM) differences in temporal maternal glucose control detectable by continuous glucose monitoring (CGM), compared to women who deliver appropriate-for-gestational-age (AGA) infants. It is unclear how these subtle changes cause LGA, but LGA has been linked to placental dysfunction. We aimed to develop an ex-vivo human placental model to mimic subtle differences in te...

Background: In a sub-group of patients with newly diagnosed pituitary adenomas, conventional MRI will fail to confidently localise the tumour. The role of molecular imaging for these patients is increasingly being recognised, both in terms of confirming diagnosis and in guiding targeted therapy; 11C-Methionine PET co-registered with volumetric MRI (Met-PET/MRCR) can enhance decision making in this group of patients. However, in some cases distinguishing t...