Endocrine Abstracts

A 58-year-old female presented with a 20-year history of resistant hypertension and hypokalaemia, with normal renal function. Investigations confirmed primary hyperaldosteronism that was not suppressed following a standard saline infusion test. CT scanning revealed a right-sided adrenal mass of 1.3 cm, with a signal intensity of −1 HU. The left adrenal was normal in appearance. A LDDST excluded ACTH-independent Cushing’s syndrome. Adrenal vein sampling confirmed rig...

Case history: A 63-year-old female was admitted to our hospital in January 2022 with neck swelling that had developed over five days with associated dysphagia to fluids. Biochemistry revealed severe hypercalcaemia with a corrected calcium of 3.82 mmol/l (2.20 - 2.60 mmol/l) and PTH of 78.7 pmol/l (1.6 - 6.9 pmol/l), and an associated AKI (creatinine of 174 umol/L from a baseline of 80). Ultrasound initially showed a left-sided 3 x 2 cm nodule suggestive of a large parathyroid ...

Non-islet cell tumour hypoglycaemia (NICTH) is a rare paraneoplastic phenomenon and there is limited guidance regarding different treatment modalities.We present two cases of NICTH focusing on the combined methods used to control hypoglycaemia.The first involves an 89-year-old gentleman diagnosed with a pelvic leiomyoma in 2003. For several years, he had experienced recurrent collapses which briefly improved following tumour emboli...

Case summary: A 55 year-old lady was referred by ophthalmology following diagnosis of bilateral central serous retinopathy, an accumulation of sub-retinal fluid at the fundus associated with Cushing’s syndrome. She also had proximal myopathy, bruising, centripetal weight gain and hypertension. Cushing’s was confirmed by 1 mg overnight DST (cortisol 581 nmol/L) and 48 hr-LDDST (407 nmol/L). 24 hr UFC was raised at 2666 nmol/L (12...

Case summary: A 55 year-old lady was referred by ophthalmology following diagnosis of bilateral central serous retinopathy, an accumulation of sub-retinal fluid at the fundus associated with Cushing’s syndrome. She also had proximal myopathy, bruising, centripetal weight gain and hypertension. Cushing’s was confirmed by 1 mg overnight DST (cortisol 581 nmol/L) and 48 hr-LDDST (407 nmol/L). 24 hr UFC was raised at 2666 nmol/L (12...

Introduction: Contrary to US guidelines, recent European guidelines do not recommend tolvaptan for the treatment of SIADH.Methods: Retrospective data collection of all inpatients treated with tolvaptan for SIADH in two UK hospitals between November 2010 and February 2014. All values were calculated as mean±S.D.Results: This case series included 61 patients (33 females, 28 males) aged 74.4±15.3 years with se...

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 ...

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...

Background: Surgical resection is the treatment of choice for phaeochromocytomas. Introduction of laparoscopic adrenalectomy (LA) led to a reduction in the number of open adrenalectomies (OA); however, there is limited information comparing the two techniques.Objectives: We report here a comparison of LA and OA operations for phaeochromocytoma performed over 20 years.Methods: We performed a retrospective review of all patients unde...

Background: A founder mutated AIP allele, R304* was previously identified in several Irish familial isolated pituitary adenoma (FIPA) pedigrees from a small region within Mid Ulster, Northern Ireland, but the allele’s general population impact remains unknown.Aims: To estimate R304* prevalence in the general population and pituitary adenoma (PA) patients and to calculate the allele’s time to most recent common ancestor (tMRCA).<p c...