Endocrine Abstracts

TSH receptor antibodies (TRAb) are autoantibodies directed against the TSH receptor, predominantly located on the thyroid epithelial cell surface. Two types of TSH receptor antibody have been found to exist in patients with autoimmune thyroid disease: thyroid stimulating antibodies (TSAb) and TSH-stimulation blocking antibodies (TSBAb). It has generally been felt that patients with positive TSAbs develop Graves’ hyperthyroidism and those with TSBAb antibodies develop hypo...

Introduction: Whilst effective, targeted checkpoint inhibitor monoclonal antibodies are associated with immune-related adverse events including endocrinopathies. Increased licensed oncological indications for these agents raise the need for effective screening, monitoring and ongoing treatment of endocrinopathies. The aim of our study was to investigate potential predictive factors that may identify patients at risk of endocrinopathies....

Introduction: Whilst effective, targeted checkpoint inhibitor monoclonal antibodies are associated with immune-related adverse events including endocrinopathies. Increased licensed oncological indications for these agents raise the need for effective screening, monitoring and ongoing treatment of endocrinopathies. The aim of our study was to investigate potential predictive factors that may identify patients at risk of endocrinopathies....

Case: A 36-year-old gentleman presented with two month history of severe headaches, vomiting, polyuria and polydipsia. He reported profound episodic sweating especially on exertion and gradual weight loss. He was hypertensive (220/110 mmHg) at presentation. He had no palpitations, anxiety, dizziness, flushing or pallor. He had no diarrhoea or abdominal pain. His only family history was of Type 2 diabetes mellitus.Investigation: Biochemical investigations...

Background: Short Synacthen test (SST) is commonly used for the assessment of the hypothalamus-pituitary-adrenal (HPA) axis after pituitary surgery. In our centre, patients are discharged on hydrocortisone on day 3 post-surgery and 9am cortisol on day 8 post-surgery is measured. Hydrocortisone is stopped if cortisol is ≥350 nmol/L on day 8. Six weeks post-surgery SST is performed and treatment adjusted. We aimed to assess the perfor...

Background: Short Synacthen test (SST) is commonly used for the assessment of the hypothalamus-pituitary-adrenal (HPA) axis after pituitary surgery. In our centre, patients are discharged on hydrocortisone on day 3 post-surgery and 9am cortisol on day 8 post-surgery is measured. Hydrocortisone is stopped if cortisol is ≥350 nmol/L on day 8. Six weeks post-surgery SST is performed and treatment adjusted. We aimed to assess the perfor...

We present the case of a 64 year old woman who presented with one month history of tiredness and 8 kg weight loss. Severe hypokalemia (2.2 mmol/l) was identified by the GP. Clinically she appeared mildly Cushingoid. Biochemical investigations showed a random cortisol significantly elevated at 2170 nmol/l, 24-hour urinary cortisol was 15 700 nmol/l(0−135). ACTH level was elevated at 7400 ng/l(0−40). The low dose dexamethasone suppression test demonstrated failure to...

Rathke’s cleft cysts (RCC) arise from the embryonic remnants of Rathke’s pouch in the anterior pituitary gland. The majority are asymptomatic and incidentally diagnosed when the pituitary is imaged for other reasons. RCCs can progress to requiring surgical intervention for hormonal and structural effects. It is unclear what factors determine RCC enlargement and over what period this occurs, hence need for long term follow-up is uncertain. We analysed our conservative...

Case history: A 57-year-old male with well controlled primary hypertension presented with acute onset severe headache while exercising, associated with nausea and vomiting. He had no visual or other neurological symptoms. The pain settled with analgesics in ED. He reported four transient similar episodes during the preceding 18 months. There were no symptoms suggestive of pituitary or other endocrine dysfunction, including hyperprolactinaemia. Clinical examination was unremark...

We present the case of a 54-year-old woman with known metastatic non-functional pancreatic NET since 2004 that developed new debilitating recurrent hypoglycemia in 2013. The patient presented in 2004 with disseminated malignancy. Radiology revealed a large pancreatic mass associated with multiple liver lesions and abdominal lymphadenopathy. Liver biopsy confirmed well differentiated NET. Initial treatment with cisplatin etoposide chemotherapy was poorly tolerated and discontin...