Endocrine Abstracts

A 17 year-old female was referred to Endocrinology with primary amenorrhoea and arrested puberty (B4 PH4 AH2). She reported breast development in line with her peer group and had experienced a single “show” of vaginal spotting aged 15 years. Although guidelines recommend baseline pelvic USS in the investigation of primary amenorrhoea, it generally only adds value in females with high LH+FSH and abnormal karyotype; indeed, it may raise undue concerns of uterine (Mulle...

Background: Diagnostic work-up for Cushing ’s syndrome (CS) can be challenging, with variable performance characteristics on screening tests. We were recently referred a young female patient with Cushing’s disease (CD) due to a microadenoma. She presented with a seizure and initial biochemical work-up included a Synacthen stimulation test (SST). Her peak cortisol rose to over 1,000 nmol/l. Exaggerated response during SST is expected in hyperestrogenic states due to e...

A 59-year-old woman with 46XY complete androgen insensitivity syndrome was referred back to our service. She also has history of hypertension and migraines. She was gonadectomised at the age of 15 years and treated with Ethinylestradiol. She married and was able to have enjoyable sex without the need for vaginoplasty or dilators. However, at 54 years she was firmly advised to stop Ethinylestradiol due to satisfactory bone density and “risks of HRT outweighing benefits&#14...

Background: The recent Get It Right First Time (GIRT) report suggests short stay pathways should be aimed for in pituitary surgery in England, with 1–2 days being realistic. We prospectively audited the length of stay (LOS) for patients undergoing transsphenoidal surgery (TSS) for sellar and suprasellar lesions at the Royal Victoria infirmary hospital (RVI) over a 2-year period, from October 2019.Methods: Data was prospectively collected for each pa...

Background: Diagnostic work-up for Cushing Syndrome (CS) can be challenging and is based on clinical and biochemical assessments. Biochemical evidence of endogenous steroid excess is demonstrated through overnight dexamethasone suppression test (ODST), low dose dexamethasone suppression test and/or 24-hour urinary free cortisol estimation (UFC). Once endogenous steroid excess is confirmed, random serum ACTH measurement is key in determining the suspected source of steroid exce...

Objective: The 250 µg short Synacthen stimulation test (SST) is the most commonly used dynamic assessment to diagnose adrenal insufficiency (AI). There are challenges to the use of the SST in routine clinical practice, including staff and resource limitation in the current COVID-19 pandemic and Synacthen cost. We aimed to investigate the value of basal cortisol level for predicting AI in our selected cohort of patients at risk of secondary adrenal insufficiency from pitui...

Introduction: Ovarian metastasis from neuroendocrine tumours is rare with < 80 reported cases. We describe a case of bilateral ovarian metastases from a primary ileal carcinoid tumour managed with somatostatin receptor agonist (SSA) therapy and surgery.Case report: A 68-year-old lady presented with abdominal pain, distension, and episodic facial flushing. Echocardiography done to investigate left bundle branch block ...