Endocrine Abstracts

Background: The National Patient Safety Alert (2020) and introduction of the NHS Steroid Emergency Card has led to the development of guidelines, publications and patient information, aiming to improve safety and management of adrenal insufficiency and prevention of adrenal crisis. Health Education England (HEE), ‘Plain English’ and NHS England guidance recommends patient information is accessible and clear to a broad range of people, to ensure patients are fully awa...

Hyperthyroidism due to Graves’ disease (GD) is traditionally managed in the secondary care ambulatory setting. Conventionally patients are required to attend for regular review at 4–12 weekly intervals, presenting practical difficulties for many adults. Nurse-led Telephone Consultations are gaining momentum in the care of long-term conditions. This Service Development Project (SDP) addressed whether or not a specialist nurse delivered telephone consultation could be ...

A 19-year-old, female of West African descent presented with a 5 months history of thyrotoxicosis. The GP had commenced carbimazole. She had continuing clinical and biochemical thyrotoxicosis TSH <0.01 (0.3–5.5 mU/l), FT4 68.0 (9–20 pmol/l) and FT3 18.9 (3.4–5.6 pmol/l). Thyroid antibodies were present at elevated titre and technetium uptake scanning showed toxic diffuse hyperplasia with an uptake function of 37%, confirming Graves&#146...

Dehydroepiandrosterone (DHEA) has been a subject of controversy for more than a decade being called ‘a miracle hormone’, the ‘elixir of life’ and ‘an anti-aging supplement’. However, recent literature has proven mild to moderate benefit in selected group of patients. Data is mostly limited to primary adrenal failure patients with adequate glucocorticoid and mineralocorticoid replacement and in hypopituitarism from variable aetiology associated wit...

Background: Pancreatic neuroendocrine tumours (pNETs) are commonly reported in patients with MEN1. The estimated incidence is reported as 40–80% of adults with MEN1 and pNETs are frequently multifocal. Guidelines recommend that CT, MRI and endoscopic ultrasound (EUS) can be used for detection and surveillance of pNETs in MEN1. MRI has been the most commonly used modality, but EUS may be more sensitive in detecting pNETs.Objective: To compare the sen...

Background: There is no consensus on the optimal timing of surgery for primary hyperparathyroidism (PHPT) in MEN1. Experienced centres recommend subtotal or total parathyroid surgery with three and a half gland surgery along with thymic removal as a favoured procedure; but long-term outcomes have rarely been reported.Objective: To investigate the indications and outcomes for surgery in patients with PHPT in MEN1Methods: Review of c...

Background: The route of oestrogen replacement has an influence on GH sensitivity in hypopituitary women, although the practical relevance of this effect remains unclear.Objectives: To compare the effects of oral and transdermal oestrogen replacement on GH requirement in adult females with hypopituitarism receiving GH replacement.Methods: This cross-sectional, observational study included 69 GH-deficient women each receiving a stab...

No guidelines exist for the management of Congenital Adrenal Hyperplasia (CAH) in adults. With no ideal glucocorticoid regimen to replicate normal physiology, best practice remains unclear. Concerns have been raised regarding overtreatment, particularly with longer acting steroids, and potential adverse effects on body composition and bone mineral density (BMD).We examined the case records of all 35 patients currently under review in our unit. Mean±...

Bladder Paragangliomas (PGLs) are a rare manifestation of sympathetic chain PGLs and occur in prone patients with SDH mutation.They often display an aggressive phenotype with metastatic disease and require long-term follow up. SDHB immunostaining plays a significant role in initial risk stratification and facilitating appropriate genetic testing. We report four cases illustrating diagnostic management and outcome issues in this rare neuroendocrine pathology; two with SDHB muta...

Bladder Paragangliomas (PGLs) constitute < 1% of all bladder tumours and 5% in our patient cohort of 80 patients with tumours due to SDH deficiency. They often display an aggressive phenotype with metastatic disease and require long-term follow up. SDHB immunostaining plays a significant role in initial risk stratification and facilitating appropriate genetic testing. We present four cases of bladder PGLs; two with SDHB mutation, one SDHA and one is awaiting extended genet...