Endocrine Abstracts

Background: Short Synacthen tests (SST) are both inconvenient and expensive, especially since the cost of tetracosactide recently increased 15-fold to over £45/ampule. A retrospective review was performed to see whether the number of SST’s could be reduced in our institution.Methods: All 76 adult inpatient (mean age 67) and 106 adult outpatient SST’s (mean age 50) from a 12-month period were reviewed for indication and whether a preceding ...

Background: Short Synacthen tests (SST) are inconvenient and expensive, especially since the cost of tetracosactide recently increased to over £45/ampule. Historic literature on the minimum 9 am cortisol required to avoid a SST ranges from 243 to 500 nmol/l and individual endocrinologist practice varies greatly.Methods: In an audit of all 182 SST’s from 1 year at our institution, either a previous 0900 h cortisol was recorded or the basal corti...

Generously supported by IPSEN)-->Moderate hyperprolactinaemia (<1000 mU/l) is a common abnormal biochemical finding in patients with end-stage renal failure (ESRF). The underlying pathophysiological mechanism is thought to be due to a combination of increased prolactin secretion as well as delayed renal clearance. There are no current clear guidelines for the treatment of ESRF-induced symptomatic hyperprolactinaemia but renal tra...

Multiple Endocrine Neoplasia is characterised by the occurrence of tumours involving two or more endocrine glands within a single patient. MEN are autosomal dominant disorders. Four forms have been described: MEN 1 due to menin mutations, MEN2 (previously MEN2A) due to mutations of a tyrosine kinase receptor encoded by the rearranged during transfection (RET) protoncogene, MEN3 (previously MEN2B) due to RET mutations and MEN4 due to cyc...

Multiple Endocrine Neoplasia is characterised by the occurrence of tumours involving two or more endocrine glands within a single patient. MEN are autosomal dominant disorders. Four forms have been described: MEN 1 due to menin mutations, MEN2 (previously MEN2A) due to mutations of a tyrosine kinase receptor encoded by the rearranged during transfection (RET) protoncogene, MEN3 (previously MEN2B) due to RET mutations and MEN4 due to cyc...

Hypoglycaemia is a common side effect of insulin treatment in patients with type 1 diabetes mellitus (T1DM). A 16-year old girl with T1DM presented with a recurrent hypoglycaemia, despite insulin dose reduction. Differential diagnosis included: overdose of insulin, Addison’s disease, hyperthyroidism, insulinoma and anti-insulin antibodies. She was admitted to the hospital for observation and investigations. She had a low random cortisol level, leading us to start steroids...

Case history: We describe a rare case of a 59-year-old woman, whose hypercortisolism was unmasked following transphenoidal surgery for Acromegaly. She presented to the Endocrine Clinic in 2006 with acromegalic features and MRI revealing a pituitary macroadenoma 20×18×18 mm. Repeat dynamic evaluation showed inadequate GH suppression (initially normal), raising the possibility of early rumbling Acromegaly. 0900 h serum cortisol was 287 nmol/l. She was started on Caberg...

Coexistence of Acromegaly with Cushing’s syndrome in the same individual is rare. We herein describe a case of a 59-year-old woman, whose hypercortisolism was unmasked following transphenoidal surgery for Acromegaly.She presented to the Endocrine Clinic in 2006 with acromegalic features and MRI revealing a pituitary macroadenoma 20×18×18 mm. Repeat dynamic evaluation showed inadequate GH suppression (initially normal), raising the possibil...

A 50-year-old man with poorly controlled type 2 diabetes mellitus on oral hypoglycaemics was under review as a diabetic outpatient. In April 2007, he developed idiopathic thrombocytopaenic purpura which, on a background of probable diabetic nephropathy, precipitated end-stage renal failure. He was treated with oral steroids and was established on haemodialysis. To achieve better glycaemic control, he was converted to twice daily insulin. His treatment dose of prednisolone was ...

Introduction: Germline aryl hydrocarbon receptor-interacting protein (AIP) mutations are responsible for 15–30% of familial isolated pituitary adenomas (FIPA). We report a 4-generation FIPA kindred with a heterozygous AIP gene deletion in exon 2, highlighting the benefits of genetic screening and management challenges in affected subjects and asymptomatic carriers.Patients: A 45y woman died of a spinal ependymoma (obligate carrier)...