Searchable abstracts of presentations at key conferences in endocrinology

ea0034p94 | Clinical practice/governance and case reports | SFEBES2014

An unusual case of recurrent hypercalcaemia: sleeping parathyroid hyperplasia?

Graham Una , Eatock Fiona , Atkinson Brew

A 60-year-old man presented with symptomatic primary hyperparathyroidism. At this time serum corrected calcium was 3.1 mmol/l (2.15–2.65 mmol/l) and after investigation bilateral parathyroid exploration was performed. A suspected adenoma was identified in the right inferior gland and removed. The remaining glands appeared normal. The adenoma was confirmed histologically. Early post-operative calcium was normal (2.48 mmol/l).He remained well and calc...

ea0013p30 | Clinical practice/governance and case reports | SFEBES2007

Two cases of “idiopathic” hypopituitarism – Was more intensive investigation required?

Lewis Anthony , Courtney Hamish , Atkinson Brew

Hypopituitarism usually is the result of a pituitary tumour or its treatment. If, however, pituitary imaging is negative then an alternative diagnosis should be sought. We present two patients initially diagnosed as idiopathic hypopituitarism in whom the underlying diagnosis was delayed with potentially serious consequences.The first case was of a 32 year old male who presented with symptoms and signs of hypogonadism. Serum testosterone (<0.7 nmol/L)...

ea0028p319 | Steroids | SFEBES2012

The use of nocturnal salivary cortisol and urinary cortisol to creatinine ratio in the evaluation of cycling in patients with Cushing’s syndrome

Graham Una , Hunter Stephen , McDonnell Margaret , Mullan Karen , Atkinson Brew

Cyclical Cushing’s syndrome is typically detected by collecting sequential daily early morning urine (EMU) samples for cortisol to creatinine ratio over a 28 day period. More recently nocturnal salivary cortisol (NSC) measurement has been shown to be a sensitive means of screening for Cushing’s syndrome. The Endocrine Society have suggested that NSC may be used to assess patients for cyclical Cushing’s however there is limited evidence that it correlates with th...

ea0028p320 | Steroids | SFEBES2012

Use of the 250mcg short synacthen test to differentiate between patients with primary aldosteronism and essential hypertension

Graham Una , Hunter Stephen , McCance David , Atkinson Brew , Mullan Karen

Aberrant and upregulated eutopic receptors have been identified in vitro in patients with primary aldosteronism (PA). We previously identified an exaggerated aldosterone response to synacthen in patients with PA versus healthy controls. In this study we aimed to evaluate whether the synacthen test differentiates between patients with PA and essential hypertension (EH). The 250 mcg intramuscular synacthen test was performed after 30 minutes recumbency in the morning and off int...

ea0021oc3.1 | Young Endocrinologists prize session | SFEBES2009

In patients with primary hyperaldosteronism (PA), careful choice of patients for surgery using a combination of adrenal venous sampling (AVS) data and results of CT scanning, results in excellent post-operative blood pressure and serum potassium responses

Graham Una , Mullan Karen , Hunter Steven , Leslie Hiliary , Ellis Peter , Atkinson Brew

It is recommended that all patients with PA who are suitable for surgery should undergo adrenal CT and AVS unless there is a large unilateral adenoma with a completely normal contralateral gland. We reviewed 100 patients diagnosed with PA. AVS was performed in 93. Different lateralisation criteria for AVS were assessed using ROC curve analysis to determine the optimal one for identifying an adenoma. We reviewed the outcomes of adrenalectomy evaluating which pre-operative chara...

ea0021p346 | Steroids | SFEBES2009

Salivary aldosterone is a useful marker of serum aldosterone in normotensive individuals

McMurray Emily , Atkinson Brew , Mullan Karen , Cundick Jennifer , Sheridan Brian , Bell Patrick

Primary aldosteronism is an important cause of secondary hypertension though its diagnosis can prove challenging. In normal individuals aldosterone release follows a diurnal pattern, with a morning peak and low levels in the evening. Aldosterone is present in saliva and due to its lipophilic nature it passes into saliva along a concentration gradient. Salivary steroid testing is well established for cortisol and testosterone, but not yet for aldosterone....

ea0015p189 | Endocrine tumours and neoplasia | SFEBES2008

Screening for Cushing’s syndrome in the diabetic clinic using nocturnal salivary cortisol

Mullan Karen , Black Neil , Burgess Colin , Leslie Hillary , Thiraviaraj Athinia , Sheridan Brian , Atkinson Brew

Sub-clinical Cushing’s syndrome has, in recent years, been described among diabetic populations but no consensus has emerged about the value of screening. We enrolled 201 consecutive diabetics attending clinic and 80 controls. Local ethics committee approval was obtained. Patients with at least 2 of the following 3 criteria were offered screening: HbA1c≥7%, BMI≥25 and history of hypertension or BP≥140/90. An 11 pm salivary sample was stored at room tempe...

ea0013p31 | Clinical practice/governance and case reports | SFEBES2007

The assessment of growth hormone deficiency following pituitary surgery – a need for greater awareness

Lewis Anthony , Courtney Hamish , Hunter Steven , McCance David , Sheridan Brian , Atkinson Brew

Pituitary surgery frequently leads to one or more anterior pituitary hormone deficiencies but the incidence of GH deficiency is unclear. The aim of our study was to establish the incidence of GH deficiency in patients post hypophysectomy. Current NICE guidelines recommend GH replacement in severely GH deficient patients who have one or more other pituitary hormone deficiencies and diminished QoL by AGHDA.Thirty-five patients (M:F 15:20; age range 23&#150...

ea0021p295 | Pituitary | SFEBES2009

Effects on insulin action of dehydroepiandrosterone sulphate replacement in hypopituitary females

McHenry Claire , Bell Patrick , Hunter Steven , Thompson Christopher , Courtney Hamish , Ennis Cieran , Sheridan Brian , McCance David , Mullan Karen , Atkinson Brew

Hypopituitary patients are at increased vascular risk. This may be partly attributable to changes in insulin action. It has been suggested that the addition of dehydroepiandrosterone sulphate (DHEAS), which is low in patients with secondary hypoadrenalism, to routine replacement may have beneficial effects on glucose metabolism. Previously, patient populations and techniques used to assess insulin action varied and overall results have been conflicting.W...

ea0021oc2.4 | Neuroendocrine tumours/pituitary | SFEBES2009

Geographical cluster of familial isolated pituitary adenoma kindreds with an identical AIP mutation

Ozfirat Zehra , Cain Josh , Chahal Harvinder , Stals Karen , Ellard Sian , Howlett Trevor , Levy Miles , Atkinson Brew , Morrison Patrick , Akker Scott , Grossman Ashley , Korbonits Marta

Mutations in the co-chaperone molecule AIP account for a predisposition to pituitary tumours in some families with familial isolated pituitary adenomas (FIPA). We now report on four apparently-unrelated families with the same mutation and originating from the same geographical area, suggesting a possible founder mutation.The index patient had gigantism (19 years, 208 cm) and had a female 4th cousin, once removed (13 years, 191 cm) with a large pituitary ...