Endocrine Abstracts

Introduction: Adrenal incidentaloma is defined as a clinically inapparent adrenal mass that is incidentally detected after imaging studies conducted for reasons other than the evaluation of the adrenal glands. Existing guidance suggests that excess catecholamine and cortisol secretion should be ruled out all cases and excess aldosterone secretion should be ruled out hypertensive patients. Certain features on CT scanning such as a Hounsfield value of over 10 are useful in diffe...

Background: Phaeochromocytoma are rare catecholamine secreting tumours and may present with hypertension, orthostatic hypotension, tachycardia and even cardiogenic shock. These tumours can easily be missed particularly in patients presenting with other disorders. We present a case of a patient with severe community acquired pneumonia who despite overwhelming sepsis was severely hypertensive.The case: JP was a 33-year-old man who was previously fit and we...

Case history: PD is a 57-year-old female teacher who presented to her GP in October 2017 with lethargy, dyspnoea and anaemia. Bone marrow biopsy followed by a CT scan of her chest and abdomen confirmed lobular breast cancer with peritoneal and bone metastases (ER+/HER2−). The patient also had an MRI scan of her head to assess for intracranial metastatic disease which was negative at the start of December 2017. She was commenced on letrozole, palbociclib and denosumab. A ...

Introduction: Hyponatremia is a common electrolyte disorder in clinical practice. We did a retrospective analysis of 100 patients admitted between Jan 2019 to June 2019 with moderate hyponatremia (Na-125-129 mmol/l) to see if there was a difference in management and outcome of the patients who were formally coded as hyponatremia and those who were not coded as such.Results: Mean age was 74 years in the coded group (n...

A 32-years-old lady was admitted with raised calcium. She had palpitation, sweating, 3 stones weight loss and neck swelling. She was diagnosed with Graves’ disease 5 months ago. Her mother had history of thyroid disease but no family history of hypercalcaemia. She had a small goitre and lid lag on examination. On admission, adjusted calcium was 3.04 mmol/l. PTH was < 0.5 pmol/l. Phosphate, vitamin-D, kidney functions, cortisol, myeloma screen and ACE levels ...

Introduction: Growth hormone secretogogues (GHS) are popular among body building communities as muscle bulking agents. We present an interesting case of new onset diabetes induced by a combination of GHS and selective androgen receptor modulators (SARMs).Case report: A 34-years body builder was referred by his GP due to a 3-week history of polyuria, polydipsia and fatigue. He had recently used one cycle of a combination tablet which contained Ibutamoren ...

Aims: The United Kingdom (UK) guidelines for management of acute pituitary apoplexy recommend the Pituitary Apoplexy Score (PAS) to objectively assess clinical severity of this rare neuro-endocrine emergency. We aimed to apply retrospectively this scoring tool to a large, single centre series of patients with acute pituitary apoplexy, and to determine its applicability in the management of these patients in the acute setting.Methods: Retrospective study ...

Introduction: Langerhans’ Cell Histiocytosis (LCH) is a rare disease, more common in children than in adults, resulting from aberrant proliferation of Langerhans’ cells, belonging to the monocyte–macrophage system.Case history: We present the case report of a 40-year-old man with a 16-year history of polyuria, polydipsia and tiredness. For 10 years he had perianal, groin, abdomen and scalp scarring, hyperpigementation along with follicles ...

Introduction: Short synacthen test (SST) is of value in assessing the adequacy of hypothalamic–pituitary–adrenal axis (HPA). Although it is extensively used, it is unclear at what morning cortisol concentration one should consider performing the SST.Methods: Retrospective observational study of consecutively performed SST (250 μg) between January 2009 and March 2010. Plasma cortisol was measured by enzyme immunoassay (Siemens Advia, Siemen...

Introduction: Hypoparathyroidism is normally treated with calcium salts and activated vitamin D. Here we report a case where synthetic 1–34 PTH (teriparatide) and i.m. vitamin D was successful in treating a case of primary hypoparathyroidism resistant to conventional treatment.Case report: A 16-year girl presented to the emergency department with vacant episodes and mild confusion. Her childhood was uneventful until the age of 12 when she developed ...