Endocrine Abstracts

Introduction: Hyponatraemia is a common cause of morbidity and mortality affecting 15–28% of inpatients. Tolvaptan is a competitive vasopressin 2 antagonist licensed to treat hyponatraemia secondary to the syndrome of inappropriate anti-diuretic hormone secretion (SIADH). There has been concern that tolvaptan treatment may lead to rapid overcorrection of sodium in a minority of patients, thus potentially leading to osmotic demyelination syndrome.Met...

Background: Ovarian granulosa cell tumours are rare, aggressive, hormonally active neoplasms.Case: A 16-year-old, nulliparous, Eastern European woman presented with a 9-month history of secondary amenorrhoea and a 2-month history of galactorrhoea. She denied headache or visual symptoms. Past medical history was unremarkable with menarche at age 14 and a previously normal menstrual cycle. She had never used hormonal contraception. Only medications were pa...

Background: Mild autonomous cortisol secretion (MACS) in patients with adrenal incidentalomas has been associated with elevated cortisol levels during the nocturnal period resulting in a disturbed cortisol rhythm. We hypothesised that administration of nocturnal metyrapone, an 11-beta-hydroxylase inhibitor, previously shown to restore cortisol rhythm in MACS patients, could reduce metabolic complications in this patient group.Met...

We present the case of 78-year-old female admitted to our hospital in January 2023 with recurrent hypoglycaemic episodes during fasting periods, particularly overnight and early morning. The patient had impaired hypoglycaemia awareness and cognitive decline. The only past medical history was of hypertension treated with bendroflumethiazide and amlodipine. During hospital stay, she experienced multiple hypoglycaemic episodes. Biochemical investigations revealed non-insulin-depe...

High grade pancreatic NETs are usually non-functional. Here, we report a case of a patient with a high grade pancreatic NET, which was initially non-functional but became functional after chemotherapy. He was initiated on a flash glucose monitoring device (FreeStyle Libre®) avoiding the need for frequent capillary blood glucose monitoring. Using this novel approach, we demonstrated an improvement in his disabling hypoglycaemia with medical treatment. A 45-year-old profess...

A 58-year-old gentlemen presented with severe neckache, sweating, feeling hot, and cold. PMH included hypertension and MI. On examination, he was clammy, with blood pressure (BP) 205/107 mmHg. Laboratory results showed leucocytosis 28.5 and TroponinT 2002 ng/l (reference range <14.0). ECG showed inferolateral ST depression. CT angiogram showed a normal aorta and a 6 cm right adrenal mass. An echocardiogram showed severe LV impairment and normal valves.<p class="abstext...

Objective: Hypothyroidism is common and predominantly managed in primary care. Symptoms are non-specific, with thyroid function tests (TFT) required for diagnosis. We sought to investigate current practice in levothyroxine prescribing in primary care.Methods: We studied the initiation of levothyroxine using the General Practice Research Database (GPRD), the world’s largest database of anonymised medical records. Individuals with i) thyroid cancer ii...

Objective: The hypothalamus–pituitary–thyroid axis profoundly influences skeletal development. Whilst the adverse effects of thyroid dysfunction on bone are well established; the effects of variation within the normal range is less clear.Design: In a subset of the Avon Longitudinal Study of Parents and Children we performed full thyroid function tests from stored samples taken at age 7. 668 children had thyroid hormone parameters within the ref...

Background: Single-nucleotide polymorphisms (SNPs) allow us to study effects of genetic variation on thyroid hormone levels. Phosphodiesterase 8B (PDE8B) is a protein responsible for cAMP generation, found in thyroid and brain tissue, but not normal pituitary tissue. Variation at this locus has been reported to influence TSH levels, but its effect on T3 and T4 had not been studied in the general population. Deiodinase 1 (DIO1) is known to influence T...

Introduction & aimHypertonic saline (HTS) is an effective treatment for severe symptomatic hyponatraemia. European Society of Endocrinology (ESE) published guidelines to standardise HTS administration in 2014, however, evidence behind the guidelines is limited by virtue of being largely derived from small retrospective studies and expert opinion. The aim of this study was to evaluate the ’real-world’ safety and efficacy of these guidelines....