Searchable abstracts of presentations at key conferences in endocrinology

ea0073aep67 | Adrenal and Cardiovascular Endocrinology | ECE2021

Diagnosing Cushing’s syndrome due to Ectopic ACTH secretion warrants high Index of Suspicion- phenotypical features may not always present

Siddique Rana , Brahma Anupam

Patients with Cushing’s syndrome usually have characteristic phenotypical features but this is not always true in case of Ectopic ACTH secretion. This is mainly because this develops more acutely and underlying malignancy can cause significant weight loss. We report a 71 years old male with background of Prostatic malignancy who was found to have new profound hypokalaemia which was resistant to treatment. There were no signs of Cushing’s syndrome but index of suspici...

ea0028p87 | Clinical practice/governance and case reports | SFEBES2012

Charge syndrome - easily missed as it presents to multiple specialties

Bhat Amar , Brahma Anupam , Jennings Adrian

A 20 year old male presented with short stature (height below 3rd centile for age since aged 13 years) and lack of secondary sexual characteristics. Past history included repaired Fallot’s Tetralogy, sensorineural deafness, repaired cleft lip and palate, learning difficulties, possible unilateral coloboma, and surgery for undescended testes. There was no significant family history. Clinical examination revealed a BMI of 22.7 (height 1.68 m, weight 64 kg). He had a narrow ...

ea0022p184 | Clinical case reports and clinical practice | ECE2010

Emergency use of etomidate in acute steroid psychosis for an adrenal cancer causing Cushing’s syndrome

Brahma Anupam , Karaczun Mark , Dhatariya Ketan

Introduction: The psychiatric consequences of inoperable Cushing’s syndrome can be difficult to manage medically. Etomidate, an imidazole derived anaesthetic agent, inhibits cortisol synthesis and may be useful in this circumstance.The case: A 57-year-old woman presented with symptoms and signs of hypercortisolism. She gave a history of recent onset intermittent right sided stabbing chest pain and worsening breathlessness.Two ...

ea0019p239 | Pituitary | SFEBES2009

Familial prolactinoma occuring in association with SDHB mutation positive paraganglioma

Brahma Anupam , Heyburn Philip , Swords Francesca

A 33-year-old male presented with headache and visual loss in May 2003. MRI pituitary showed a large tumor arising from pituitary fossa extending to suprasellar cistern compressing the optic chiasm with features recent infarction. He subsequently underwent urgent trans-sphenoidal decompression and a necrotic prolactinoma was excised with full recovery of his vision. His prolactin level remained elevated and so he was treated with cabergoline. Further questioning revealed that ...

ea0034p271 | Obesity, diabetes, metabolism and cardiovascular | SFEBES2014

Evaluating β-hydroxybutyrate as indicator for early termination of 72 h fast for spontaneous hypoglycaemia

Cozar Octavian-Ionut , Gorick Sondra , Brahma Anupam , Swords Francesca

Background: The gold standard investigation for suspected spontaneous hypoglycaemia is the supervised 72 h fast. This aims to ‘capture’ a hypoglycaemic episode, to confirm Whipple’s triad, and to measure simultaneous insulin and C-peptide levels. These should confirm or refute endogenous hyperinsulinaemia.75% patients with confirmed insulinoma actually develop hypoglycaemia within 24 h of fasting. However, some confirmed cases require sign...

ea0028p349 | Thyroid | SFEBES2012

Audit of radioiodine in management of benign multinodular goitres at norfolk and Norwich university hospitals

Krishnan Leena , Mackay James , Brahma Anupam , Swords Francesca

Background: The Royal College advises 500–800 MBq of Radioiodine(RAI) for toxic multinodular goitres (MNG), and 400–800 MBq RAI for euthyroid MNG. In our institution, a standard low dose of 370 MBq has traditionally been given to all patients with benign thyroid disease. This audit examined whether outcomes are optimal with low dose therapy, and whether a variable dose protocol should be adopted.Patients and Methods: We analysed 49 patients at ...

ea0021p63 | Clinical practice/governance and case reports | SFEBES2009

Case of post menopausal steroid cell ovarian tumor

Brahma Anupam , Venu Maya , Duncan T , Geevarghese C

Androgen secreting ovarian tumours account for 0.1% of ovarian tumours. They can appear at any age (mean, 42 years) and can be slow growing.We report a case of androgen secreting ovarian tumour diagnosed at a delayed stage. It is unusual as it evaded diagnosis because of various factors, which we believe should be learning lesions.A 56-year-old lady with medical history of sub-arachnoid haemorrhage (SAH), presented with features of...

ea0015p79 | Clinical practice/governance and case reports | SFEBES2008

Not another case of chronic fatigue syndrome or polycystic ovarian disease

Brahma Anupam , Barakat O , Gorick Sondra , Temple R

Introduction: We present an interesting case of cyclical Cushing’s syndrome who became too unwell to loose her job and confidence as a result of the condition prior to diagnosis of her condition.Case report: A 44-year-old social worker referred by GP in 2007 for investigation of ‘possible hypo- or hyperadrenalism’. She had been diagnosed with polycystic ovary syndrome in 2002 (based on symptoms and ovarian ultrasound) and recently diagnose...

ea0081p763 | Late-Breaking | ECE2022

Actions taken for prevention of adrenal insufficiency in adult patients who are at risk - audit report

Jayaweera Jayamalee , Sheikh Sara , Higgoda Rakitha , Kundrapu Karthayani , Jajah Bilal , Brahma Anupam

Background: Adrenal insufficiency (AI) is can be often under recognised condition in the clinical practise which can potentially result in adrenal crisis or even death if not treated properly. Identification of patients who are at risk of developing AI is important in order to take appropriate steps in minimising unwanted incidents. Objectives: Study aims to assess whether we identify patients who are at risk of AI and take recommended precautions.<p...

ea0025p71 | Clinical biochemistry | SFEBES2011

Does the glucagon challenge test add to the utility of a 72 h fast for spontaneous hypoglycemia?

Brahma Anupam , Romans Steven , Gorick Sondra , Myint K Swe , Swords F M

Supervised 72 h fast is historically the gold standard screen for spontaneous hypoglycaemia. Consensus guidelines published in 2009 suggested that β-hydroxy-butyrate levels be measured every 6 h, and the glucose response to an i.v. injection of glucagon be assessed at the time of documented hypoglycaemia, or at the end of the 72 h fast. We incorporated these recommendations into our protocol, and here examine the results of the first 10 cases.A rise...