Endocrine Abstracts

Case: A 73 year old man was seen in eye clinic with 5 month history of visual problems. He was diagnosed with bilateral glaucoma and early Cataracts. His vision was not improving despite eye drops and new glasses thus cranial imaging was requested. He also complained of feeling off balance and tiredness. He denied headache or galactorrhoea. Examination: Bitemporal hemianopia (L>R). Investigations: CT head scan – Pituitary Macroadenoma 3.6×3.1×3.8 cm, with di...

Background: Generally Endocrinologists strive to diagnose conditions biochemically prior to radiological investigation. Pituitary incidentalomas are observed in 10% of pituitary MRIs and together with stress induced hyperprolactinaemia, 10–20% of patients receive dopamine agonists (DAs) without a definite diagnosis. Menstrual imbalance is a common symptom of hyperprolactinaemia which can have multiple origins (e.g. hypothalamic, pituitary or ovarian). DAs have side effect...

Case: A 61 year old female, presented to ENT in July ’17 with 6 month history of left sided neck swelling, gradually increasing in size over the last 1 month prior to presentation. She complained of tenderness over the swelling and pain and discomfort around her left shoulder. She denied any problems with her voice, breathing or swallowing. Her past medical history consisted of recurrent UTI’s, renal stones and medullary sponge kidney. She smokes 15 cigarettes per da...

Aims: Endocrine Society (ES) acromegaly guidelines (2014) addressed complication screening. Uncontrolled acromegaly is associated with elevated cardiovascular mortality due to risk factors including hypertension (HT), diabetes mellitus (DM), obstructive sleep apnoea (OSA), and with an increased risk of colorectal cancer and polyps among other types of neoplasias. We audited our clinical practice with regards to acromegaly complication screening.Methods: ...

Aim: Endocrine Society (2016) published guidelines for hormonal replacement in hypopituitarism. Central hypothyroidism (CH) is defined as fT4 below reference range and mild CH is defined as fT4 in the low-normal range with suggestive symptoms in the context of pituitary disease. In patients with panhypopituitarism levothyroxine in doses sufficient to achieve fT4 levels in the upper half of the reference range is recommended. In our centre...

Aims: Endocrine Society (ES) acromegaly guidelines (2014) addressed complication screening. Uncontrolled acromegaly is associated with elevated cardiovascular mortality due to risk factors including hypertension (HT), diabetes mellitus (DM), obstructive sleep apnoea (OSA), and with an increased risk of colorectal cancer and polyps among other types of neoplasias. We audited our clinical practice with regards to acromegaly complication screening.Methods: ...

Aim: Endocrine Society (2016) published guidelines for hormonal replacement in hypopituitarism. Central hypothyroidism (CH) is defined as fT4 below reference range and mild CH is defined as fT4 in the low-normal range with suggestive symptoms in the context of pituitary disease. In patients with panhypopituitarism levothyroxine in doses sufficient to achieve fT4 levels in the upper half of the reference range is recommended. In our centre...

Introduction: There is great variation in management of perioperative cortisol management in patient’s undergoing pituitary surgery across UK Hospitals. We evaluated safety and effectiveness of standards followed in ARI. The aim of audit was to confirm safety, improve knowledge and change practice for better patient care if needed based on information gained from the available data.Description of methods/design: We evaluated 30 patients who have und...

Introduction: Minimally invasive surgical treatment of primary hyperparathyroidism (PHPT) requires optimal preoperative localisation imaging. Parathyroid four-dimensional CT (4D-CT) has been reported to provide greater sensitivity than MIBI-SPECT/CT in localizing parathyroid adenomas. We analysed the additional value of 4D-CT in our cohort of PHPT patients.Materials and methods: Patients who attended our parathyroid clinic between February 2016 and April...

Case: A 33 year old gentleman presented with significantly raised testosterone levels, testicular pain, erectile dysfunction and weight loss. He denied use of anabolic steroids. Upon physical examination he looked muscular and tanned. Left testicle was tender with no palpable mass. Raised androgen levels (Siemens immunoassay) were confirmed by liquid chromatography tandem mass spectrometry (LC-MS/MS), ruling out assay interference. In view of his ongoing denial of substance mi...