Searchable abstracts of presentations at key conferences in endocrinology

ea0059cmw2.2 | Workshop 2: Endocrine emergencies | SFEBES2018

A phaeochromocytoma crisis

Casey Ruth T

A phaeochromocytoma is a catecholamine secreting tumour arising from the adrenal medulla and a paraganglioma refers to its extra adrenal counterpart, which can develop from sympathetic or parasympathetic tissue anywhere from the skull base to the pelvis. Presenting symptoms of these rare tumours are most commonly related to catecholamine excess, and include headache, palpitations, paroxysmal hypertension, anxiety, abdominal pain and excessive sweating. A phaeochromocytoma cris...

ea0044p127 | Neoplasia, cancer and late effects | SFEBES2016

A review of the diagnostic sensitivity of plasma metanephrine testing in patients with SDH gene mutations

Abraham Shalin , Casey Ruth , Pitfield Deborah , Challis Ben , Simpson Helen

Phaeochromocytomas (PC) are tumours of the adrenal medulla and paragangliomas (PGL) refer to their extra-adrenal counterpart arising from sympathetic or parasympathetic tissue. Mutations in the citric acid cycle enzyme succinate dehydrogenase (SDH) predispose to PC/PGL. Clinical practice guidelines suggest that plasma metanephrine and normetanephrine levels measured in the supine position should be used in the first instance for biochemical diagnosis, and those with positive r...

ea0038p118 | Clinical practice/governance and case reports | SFEBES2015

Management of patients with adrenal insufficiency attending Galway University Hospital compared with current best practice

Cormican Sarah , Casey Ruth , O'Shea Paula , Bell Marcia

Introduction: Patients with adrenal insufficiency (AI) lack endogenous cortisol and require oral hydrocortisone. In primary AI (PAI) endogenous aldosterone synthesis is also lost and patients require oral fludrocortisone. Important long-term issues include wearing MedicAlert jewellery (MAJ) and adequacy of steroid replacement including fludrocortisone, assessed by plasma–renin activity (PRA).We identified patients with AI attending our unit and aime...

ea0037gp.03.06 | Adrenal (2) | ECE2015

Applying a new decision threshold to an old test: does the measurement of plasma metanephrines in patients fasting and supine improve diagnostic sensitivity?

Casey Ruth , Bell Marcia , Dennedy Michael , O'Shea Paula

The recently published Endocrine Society Clinical Practice guideline on phaeochomocytoma and paraganglioma (PPGL) recommends measuring plasma metanephrines (PMets) with patients in the supine position after an overnight fast and using appropriately defined reference intervals.1 Studies have shown higher diagnostic sensitivities using the latter pretesting criteria.2 However, this testing protocol is resource intensive and arguably impractical in routine c...

ea0037ep1268 | Clinical Cases–Thyroid/Other | ECE2015

Hypercalcaemia; a silent indolent course?

Casey Ruth , Higgins Larissa , Lowery Aoife , Kerin Michael , Dennedy Conal

A 83-year-old lady presented to hospital with a one week history of malaise, dyspnoea and chest pain. Her admission bloods revealed a markedly elevated calcium of 4.16 mmol/l. Further investigations revealed a PTH of >5000 ng/l. Clinically the patient had poor dentition which had developed over the past 3 years and a history of episodic abdominal pain and constipation. For investigation of primary hyperparathyroidism, she had an ultrasound neck, which revealed an enlarged ...

ea0052p39 | (1) | UKINETS2017

A case of carcinoid crisis despite high dose somatostatin analogue therapy peri-operatively

Pitfield Deborah , Casey Ruth , Seetho Ian , Shaw Ashley , Buscombe John , Roe Paul , Buczacki Simon , Challis Ben

Introduction: Carcinoid crisis is a life threatening endocrine emergency. It remains unclear whether there is an optimal dose of prophylactic somatostatin analogue (SSA) therapy in the peri-operative periodCase Study: A 62 year old lady with a new diagnosis of metastatic carcinoid disease was electively admitted for a right hemicolectomy for a well differentiated neuroendocrine tumour in the terminal ileum. A multi-disciplinary decision was made to offer...

ea0069oc3 | Oral Communications | SFENCC2020

A rare case of bilateral carotid body paragangliomas and associated Burkitt’s lymphoma in patient with a germline SDHB mutation

MacFarlane James , Bisambar Chad , Challis Ben , Park Soo-Mi , Giger Olivier , Aloj Luigi , Casey Ruth

Section 1&2: Case history and investigations: We report the case of a 52-year-old man with recurrent immunodeficiency-related Burkitt’s lymphoma. 11 years following remission of his disease he presented with a firm lump in the parotid region. A biopsy showed histopathological evidence of a relapse. An 18F FDG PET was undertaken to determine the extent of the disease and response to R-DHAX chemotherapy. Areas of high uptake were identified in both sides of t...

ea0069oc10 | Oral Communications | SFENCC2020

Hiding in plain sight: A case of severe refractory primary hyperparathyroidism due to an intrathyroidal ectopic parathyroid adenoma

Glasgow John C , Chatterjee Krishna , Fish Brian , Berman Lol , Marker Alison , Moran Carla , Casey Ruth

Section 1: Case history: A 30 year-old female patient with a background of symptomatic primary hyperparathyroidism diagnosed in 2008 and a history of two failed neck surgeries, was reviewed in clinic complaining of persistent symptoms of hypercalcaemia. Previous pre-operative neck imaging had failed to localise a parathyroid adenoma and the patient had undergone two neck explorations by an experienced ENT surgeon; one which removed thymic tissue and the other which removed a m...

ea0065cmw2.2 | Hyperparathyroidism | SFEBES2019

Genetic testing in hyperparathyroidism – who to test and why

Mariathasan Sashi , Andrews Katrina , Thompson Edward , Armstrong Ruth , Simpson Helen , Casey Ruth , Park Soo-Mi

Primary hyperparathyroidism (PHPT) is a common endocrine disorder with a prevalence of 0.86% in Europe. Approximately 10% of cases are hereditary. Syndromic PHPT occurs as part of multiple endocrine neoplasia (MEN)1, MEN4, MEN2A and hyperparathyroidism jaw tumour syndrome. Non-syndromic causes include familial hypocalciuric hypercalcaemia. Establishing the underlying genetic cause allows for targeted, cost effective management. Current guidelines recommend that genetic testing...

ea0065op1.3 | Adrenal and Cardiovascular | SFEBES2019

Combining 11C-metomidate PET/CT and 18F-FDG PET/CT – a new approach to phenotyping indeterminate adrenal lesions

Senanayake Russell , Bashari Waiel , Bisambar Chad , Mendichovszky Iosif , Cheow Heok , Kosmoliaptsis Vasilis , Casey Ruth , Gurnell Mark

Background: 11C-Metomidate (MTO)-PET/CT has recently found utility as an alternative to adrenal vein sampling for lateralisation in primary aldosteronism. MTO binds with high affinity to 11b-hydroxylase (CYP11B1) and aldosterone synthase (CYP11B2) and can be considered an adrenocortical-specific tracer. We and others have therefore hypothesised that combining MTO-PET/CT with 18F-FDG(FDG)-PET/CT would permit indeterminate adrenal lesions ...