Endocrine Abstracts

INTRODUCTION: Gastrinomas usually arise in pancreas or duodenum and may be small and difficult to localize. These tumours are multiple in 50% of sporadic cases but in MEN1 this figure rises to 90%.CASE REPORT: Our patient presented aged 24 with a neck mass. Investigations confirmed primary hyperparathyroidism and four-gland parathyroidectomy confirmed hyperplasia. When normocalcaemic, her fasting plasma gastrin level was noted to be 129 pmol/l (NR<40)...

Introduction: Muslims including many patients with diabetes mellitus practice dawn to sunset fasting during the month of Ramadan. Using CGM recorded data we have investigated glucose excursions with Ramadan fasting in a group of patients with type 2 diabetes mellitus and good glycaemic control.Methods: Thirty-four patients with type 2 diabetes mellitus (8 female, 26 male, age 46.5±11.1 years, HbA1c 6.9±1.0%, BMI 29.5±6.5 kg/m2) ...

ObjectiveTo assess the results of bilateral adrenalectomy and further assess the relevance of Nelson's syndrome as a complication of bilateral adrenalectomy.Patients33 patients treated by bilateral adrenalectomy at the Hammersmith Hospital were identified (earliest operation performed in 1958). Although all bilateral adrenalectomies in recent years were included, it was not possible to confirm that all bilate...

Background:Galectin-3, a beta-galactosidase binding lectin, has been reported to be preferentially expressed in thyroid malignancies by many authors. Moreover, it has been claimed that galectin-3 is a useful adjunct to fine-needle aspiration (FNA) in the diagnosis of follicular thyroid lesions, a notorious pitfall of this test. Although galectin-3 does seem to be expressed more often in malignant thyroid lesions, especially papillary carcinomas, it is fr...

A 56 year old female on treatment for colonic Tuberculosis was referred for investigation of possible Cushing's Syndrome. She initially presented with hypertension, hypokalaemia, and proximal myopathy. Repeated Urinary Free Cortisols were elevated at 730, 738, 520 nmol/L, (normal range= 55-270 nmol/L). The patient failed to suppress on low dose dexamethasone suppression, LDDST, (0.5 mg 6 hourly for 48 hours), baseline cortisol= 390 nmol/L, 48hour cortisol = 595 nmol/L, but sup...

Transphenoidal hypophysectomy is often carried out to remove ACTH-secreting tumours of the pituitary. A postoperative serum cortisol of <50nmol/l usually indicates cure of the disease but after other audits found persistent cases, 'remission' is thought to be a more appropriate term.Charing Cross Hospital is the tertiary neurosurgical centre for West London where a single, dedicated pituitary surgeon was appointed in 1995. We analysed the success of e...

Midnight Cortisol RevisitedD Noimark, MT Barakat, K. Meeran, JF ToddEndocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, LondonBackground: The diagnosis of Cushing's syndrome must be established before any attempt at differential diagnosis. The diagnosis of Cushing's syndrome can be made initially on an outpatient basis with the measurement of 24 hour urinary free cortisol ...

Midnight Cortisol RevisitedD Noimark, MT Barakat, K. Meeran, JF ToddEndocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, LondonBackground: The diagnosis of Cushing's syndrome must be established before any attempt at differential diagnosis. The diagnosis of Cushing's syndrome can be made initially on an outpatient basis with the measurement of 24 hour urinary free cortisol ...

A 56 year old female on treatment for colonic Tuberculosis was referred for investigation of possible Cushing's Syndrome. She initially presented with hypertension, hypokalaemia, and proximal myopathy. Repeated Urinary Free Cortisols were elevated at 730, 738, 520 nmol/L, (normal range= 55-270 nmol/L). The patient failed to suppress on low dose dexamethasone suppression, LDDST, (0.5 mg 6 hourly for 48 hours), baseline cortisol= 390 nmol/L, 48hour cortisol = 595 nmol/L, but sup...

A 24-year old male who, was normal at birth, became listless and volume depleted at 3 weeks of age. Investigations yielded an Addisonian picture (serum Na+ 115 mmol/l; K+ 8.2 mmol/l; urea 15.8 mmol/l). Serum 17-hydroxyprogesterone (17-OHP) levels were measured and found to be high (2,564 nmol/l). Urinary 17-oxosteroids and 17-OHP were also elevated. The neonate was thought to have 21-hydroxylase-deficient congenital adrenal hyperplasia (CAH) and therapy with fludrocortisone an...