Endocrine Abstracts

Introduction: Aryl hydrocarbon receptor interacting protein (AIP) mutated Acromegaly is a complex rare disease. AIP mutations are associated with an aggressive, inheritable form of acromegaly that responds poorly to SST2-specific somatostatin analogues (SSAs). Literature reports demonstrate that second generation SSA, Pasireotide LAR, is superior to first generation SSAs in treating acromegaly with AIP mutation. Treating acromegaly with AIP mutation could be quite challenging....

Case report: A 52-year-old woman developed painful anterior neck swelling seven days after receiving the first COVID-19 vaccine AstraZeneca (AZ). Investigations showed TSH 0.14 mIU/l, CRP 34 mg/l and TRAb 0.3 IU/l. A neck Doppler ultrasound scan on day 15 showed features of thyroiditis. On day 21, she was hyperthyroid with TSH <0.02 mIU/l and free T4 70.3 pmol/l. COVID-19 test was negative, and she was advised to start Carbimazole and propranolol but took only the beta-blo...

Introduction: Carcinoid crisis represents a rare medical emergency with potentially fatal manifestations that can occur in patients with neuroendocrine tumours (NETs). The condition is caused by a substantial release of vasoactive metabolites from the NETs during diagnostic or therapeutic interventions. However, in rare instances, it can occur spontaneously. Here, we report a patient who developed a carcinoid crisis following radioactive iodine131I (RAI) treatment f...

Introduction: Distinguishing arginine vasopressin deficiency (AVD) from primary polydipsia (PP) can be challenging in clinical practice. Copeptin is produced in equimolar amount to AV and is considered diagnostic biomarker to establish the diagnosis of AVD with and without provocative testing.Methods: Patients referred with polydipsia, hypotonic polyuria (>3L/day) and normonatraemia had overnight fasting plasma copep...

Background: There is a well-documented relationship between lithium exposure and thyroid dysfunction via multiple mechanisms. Lithium is commonly associated with goitre, hypothyroidism, and subclinical hypothyroidism. Lithium-induced autoimmune hyperthyroidism is rare and poorly understood. We report a case of autoimmune thyroiditis, Graves’ disease (GD), in a patient with longstanding primary hypothyroidism believed to be induced by Lithium.<p class=...

Introduction: Avascular necrosis of the femoral head (AVN) is most commonly a consequence of glucocorticoid excess and is believed to be due to osteocyte apoptosis. It can also be due to vascular occlusion or trauma. We describe a patient with congenital adrenal hyperplasia secondary to 17-hydroxylase deficiency who presented with osteoporotic vertebral fractures and atraumatic avascular necrosis of the femoral head. She was also found to have mild cardiomyopathy.<p class=...

Introduction: Multiple myeloma (MM) is a haematological disorder characterised by an aberrant rise in monoclonal paraprotein. Intrasellar plasmacytomas can be infrequent MM manifestations. They are challenging to diagnose and frequently mimic pituitary adenomas; however rarely present with pituitary apoplexy. We describe a patient with pituitary apoplexy-like symptoms, subsequently diagnosed with MM, whose intrasellar mass entirely resolved after chemotherapy....

Introduction: In patients with neuroendocrine tumours (NETs) somatostatin analogues are used to control symptoms in patients with functioning tumours and as antiproliferative agents in those with non-functioning tumours. During COVID-19, the ‘Sandostatin Your Choice’ service was terminated by Novartis, removing home care nurses from administering the analogue in patients’ homes. The first generic version of depot octreotide was Olatuton® produced by Teva, a...

Background: Carcinoid heart disease (CHD) is a rare carcinoid syndrome (CS) manifestation, often linked to liver metastasis releasing vasoactive amines. CHD can also result from ovarian neuroendocrine tumours (NETs), an uncommon association.Cases Presentations: We reviewed three female patients at our NET centre, averaging 63years of age (59-67years). They all had primary ovarian NETs causing CS and CHD.<p class="abs...

Introduction: IGF-1 dependence on sex is a well-known fact; however, whether IGF-1 is also influenced by body weight is still questionable, and the mechanism of a potential relationship between GH, IGF-1 and body weight is not fully explained. The effect of gender (or rather oestrogens) on IGF-1 is visible in acromegaly - women are diagnosed at an older age than men (approximately 4 years) (potentially by suppressive effect on the axis of GH-IGF-1). The aim of the study was to...