Endocrine Abstracts

Introduction: A short-synacthen test (SST) is routinely used to diagnose hypoadrenalism, however, some authors suggest using morning serum cortisol as an initial screening test to rule out hypoadrenalism. We assessed the utility of a morning cortisol as a screening test when compared with the outcome of SST.Methods: We retrospectively analysed SSTs carried out in our endocrine outpatient clinic in the last 3 years (649 results). Of these, 113 were identi...

We present two cases of alternative approaches to treating endocrine disease. Case 1: A 55-year-old man became steroid dependent in 2017, following a skiing accident and C3/4 fracture, for which he received 13-months of high-dose hydrocortisone. Upon cessation, he developed adrenal crisis, confirmed on short synacthen test. Hydrocortisone replacement therapy was begun. His dose was doubled, then tripled to control his symptoms, in addition to frequent re...

Introduction: In 2017 the Roche cortisol assay underwent a generation update. The increased specificity of this assay was expected to lower cortisol results by approximately 30%. Based on a local consensus, the 30 min short Synacthen Test (SST) cortisol was lowered from 550 to 420 nmol/l. With the previous assay, a morning cortisol of ≥375 nmol/L gave a 99% PPV of an SST ‘pass’.Aims: • To compare the numbers of SSTs and the SST pass ...

Case History: A thirty year old female presented to hospital after a first seizure. She had no significant past medical history. She had a one week history of recurrent frontal headaches and had noticed irregular periods. There were no clinical features of acromegaly. CT and MRI brain imaging showed a 5 cm mass arising from the pituitary fossa, extending into the suprasellar cistern and anterior cranial fossa. There was evidence of mass effect on the optic nerves and optic chi...

Case history: A 43-year-old Syrian woman presented with severe right thigh pain following a fall from standing height. Progressive hip and back pain in the preceding 18 months resulted in her mobilizing with crutches. Past medical history included a reported bony tumour resected from her wrist three years earlier, clavicle fracture and previous renal calculi. She took no regular medications.Investigations: Pelvic radiograph showed a right proximal femora...