Searchable abstracts of presentations at key conferences in endocrinology

ea0055oc8 | National Clinical Cases | SFEEU2018

Recurrent severe hypoglycaemic episodes in the context of insulin receptor antibodies

Ronneberger Ruth , Nobeebux Afizah , Manova Yuliya , Rumsby Gill , Lam Francis , Woodward Gary , Isenberg David , Ehrenstein Michael , Halsall David , Church David , Semple Robert , Simpson Helen

We present a 32-year-old woman with recurrent hypoglycaemic episodes and a history of juvenile onset SLE. Over months, she experienced severe hypoglycaemic episodes with unconsciousness, occuring mainly in the early morning resulting in several hospital admissions. The patient had to take precautions like eating snacks between meals and before going to bed, and even setting an alarm clock to eat a bowl of porridge at 0200 h. She was of normal weight, did not present with any h...

ea0013s33 | Animal disease, paradigm for human conditions | SFEBES2007

Hyperadrenocorticism – current treatment options

Church David

Spontaneous hyperadrenocorticism in dogs and cats is most commonly (∼90%) caused by a functional pituitary tumour. As pituitary surgery is still an uncommon practice in veterinary science, these animals are generally managed medically using either mitotane or trilostane.The traditional method of managing PDH in dogs has been long term mitotane (o, pDDD) administration. The essence of this regime is to destroy most of the hyperplastic adrenal cortex...

ea0069oc6 | Oral Communications | SFENCC2020

MGES: Monoclonal Gammopathy of Endocrine Significance?

Ratnayake Gowri , Church David , Semple Robert , Cavenagh James , Drake William

A 65 year-old male was evaluated at another hospital for frequent episodes of fainting preceded by sweating, palpitations fatigue and hunger over several years. There was no personal or family history of diabetes mellitus. Hypoglycaemia was confirmed on a supervised fast and, guided by some equivocal uptake on a dotatate scan, he underwent a distal pancreatectomy, but the symptoms persisted. He was referred to our centre. He reported relentless weight gain and a need to eat po...

ea0065p243 | Metabolism and Obesity | SFEBES2019

Mass spectrometric characterisation of circulating proinsulin-derived peptides in insulin autoimmune syndrome

Church David , Halsall David , Gribble Fiona , Reimann Frank , Semple Robert , Kay Richard

Autoimmune immunoglobulins directed against peptide hormones are well-described. These are often clinically benign, but may cause a deleterious effect on the accuracy of clinical immunoassays. A notable exception is Insulin Autoimmune Syndrome (IAS, also known as Hirata disease), where antibody-binding has a direct effect on insulin kinetics resulting in aberrant glucose control. Current methods to diagnose IAS rely on crude immune-subtraction techniques such as polyethylene g...

ea0044oc5.4 | Diabetes Mellitus and Metabolism | SFEBES2016

Two contrasting cases of spontaneous severe hypoglycaemia secondary to anti-insulin antibodies (Insulin Autoimmune Syndrome / Hirata disease)

Moorthy Myuri , Freudenthal Bernard , Church David , Kisalu Judith , Woolman Emma , Hale Amy , Beynon Huw , Karra Efthimia , Cohen Mark , Khoo Bernard

IAS is a very rare condition in which anti-insulin antibodies carry high concentrations of insulin in suspension in circulation. Hypoglycaemia occurs when insulin is released from the antibodies during fasting or post-prandially.We present two cases. Patient-A is a 52-year old Thai obese female, with acanthosis nigricans and a strong family history of T2DM. Patient-B is a 28 year-old normal- BMI Caucasian female with an unremarkable history. None of the ...

ea0069p1 | Poster Presentations | SFENCC2020

Two contrasting cases of spontaneous severe hypoglycaemia secondary to anti-insulin antibodies (Insulin Autoimmune Syndrome / Hirata disease)

Eltayeb Randa , Banu Zeenat , Aziz Umaira , Eldigair Hiba , Kisalu Judith , Woolman Emma , Beynon Huw , Church David , Kenneth Robert , Khoo Bernard , Cohen Mark , Karra Efthimia

Insulin Autoimmune Syndrome (IAS)/Hirata disease is a very rare condition in which anti-insulin antibodies result in accumulation of high circulating concentrations of insulin in complexes. Hypoglycaemia in IAS occurs when insulin is released from the antibodies during fasting. We present two contrasting cases of Hirata disease. Both patients presented with symptomatic hypoglycaemia. Patient-A is a 52-year old obese Thai female, with acanthosis nigricans and a strong family hi...

ea0065p236 | Metabolism and Obesity | SFEBES2019

Case reports of immunosuppression therapy for anti-insulin receptor and anti-insulin antibodies in patients attending the national severe insulin resistance service

Liu Charlotte Jenkins , Adams Claire , Church David , Flanagan Catherine , Gaff Lisa , Jayne David , Melvin Audrey , O'Rahilly Stephen , Pizirtzidou Eirini , Savage David , Semple Robert , Withers Elaine , Stears Anna

Introduction: Immune mediated cases of severe insulin resistant diabetes are very rare. We report responses to immunosuppression with rituximab in two patients.Case 1: A 31 year old black African female, BMI 22.84 kg/m², was referred with new onset diabetes, diagnosed shortly following a miscarriage. She had weight loss, acanthosis nigricans, nocturnal hypoglycaemia and severe hyperandrogenism . She was on an insulin pump and required >1000 units in...

ea0035p327 | Clinical case reports Thyroid/Others | ECE2014

Hirata disease: a rare form of hyperinsulinemic hypoglycemia

Cardoso Luis , Church David , Rodrigues Dircea , Alves Marcia , Guelho Daniela , Saraiva Joana , Moreno Carolina , Dantas Rosa , Vicente Nuno , Semple Robert K. , Carrilho Francisco

Introduction: Insulin autoimmune syndrome or Hirata disease is a rare cause of hypoglycemia without prior insulin exposure. Approximately 400 cases were reported, mostly in Japan. It’s associated with other autoimmune diseases or exposure to sulfhydryl-containing drugs.Case report: A 56-year-old Caucasian woman presented with a 20-month history of hypoglycemia ameliorated by sugar intake. She had a past history of autoimmune thyroiditis, asthma and ...