Endocrine Abstracts

Introduction: Hen corticosteroids are utilised for their anti-inflammatory properties, adrenocortical atrophy may result. Abrupt steroid withdrawal or intercurrent illness can precipitate acute adrenal crisis. We report two cases of adrenal crisis which resulted from withdrawal of immunosuppressive steroid therapy.Case report: i) A 74-year-old gentleman was admitted with hypotension (BP 80/40), severe hyponatremia (Na:118 mmol/l) and acute renal failure ...

Introduction: Some patients complain of excessive daytime somnolence following pituitary surgery.Aim: To investigate the presence of obstructive sleep apnoea (OSA) following surgery for non functioning pituitary adenomas (NFPA).Design and methods: We assessed the prevalence of OSA in 16 routinely selected patients following surgery for NFPA and 13 obese controls attending a tertiary referral centre, by means of the Epworth Sleepine...

Severe hyponatraemia (SHN, <120 mmol/l) is reported to be associated with mortality as high as 50%; although there are several international guidelines for management of SHN, there are few data on the impact of treatment. We have longitudinally audited our treatment outcomes of SHN. We present the results of three audit periods, of six months each, from 2005, 2010 and 2015. The three periods represented; 2005, prior to hospital policy for SHN, 2010, audit of impact of poli...

Introduction: The natural history of adipsic diabetes insipidus (ADI) is not completely understood. Isolated case reports suggest occasional recovery of adipsia. We present the follow up of a cohort of 12 patients with ADI.Setting: National pituitary unit with interest in diabetes insipidus.Methods: ADI was identified by demonstrating absent thirst and AVP responses to hypertonic saline infusion. Results 12 patients with ADI were i...

Background: Patients taking corticosteroids for immune suppression are vulnerable to adrenal crisis during intercurrent illness or if steroids are stopped abruptly. Although patients on glucocorticoids for adrenal failure are routinely provided with sick day rules, we wished to ascertain whether patients on immunosuppressive steroids are appropriately counselled.Aim: This study sets out to compare patient awareness of steroid sick day rules in endocrine ...

Introduction: Excess mortality due to hyponatraemia is well documented but it is not clear whether the mortality associated with SIADH is different to that associated with non-SIADH hyponatraemia (NSH).Methods/design: Prospective evaluation of all patients admitted with or developing hyponatraemia in a tertiary hospital (pNa <130 mmol/l) in January 2015. Diagnosis of SIADH was based on standard clinical and biochemical criteria (pNa, spot urine sodiu...

Introduction and objectives: Transsexuality refers to discrepancy between the assigned sex/gender at birth and the one that the subject identifies with. The use of the cross hormone treatment as sex/gender change method implies the necessity of monitorize the hormone levels and potential treatment risks. Our study tries to evaluate the relationship between the hormone changes and the changes in the cardiovascular risk factors and the bone mineral density.<p class="abstext"...

Objective: To study the differences in the metabolic profile of patients with non-functioning adrenal adenomas (NFA) and autonomous cortisol secretion (ACS).Methods: 143 patients diagnosed of adrenal incidentaloma (AI) between 2010 and 2018 were retrospectively analyzed. AI was defined as an adrenal mass≥1 cm, accidentally discovered by radiologic examination. ACS was confirmed by serum cortisol post-dexamethasone suppression test (Nugent)≥3 ...

Context: The syndrome of inappropriate antidiuresis(SIAD) is the commonest cause of hyponatraemia. Data on the aetiology of SIAD is mainly derived from retrospective studies, often with poor ascertainment of minimum criteria for correct diagnosis. Although central adrenal insufficiency(CAI) is known to cause euvolaemic hyponatraemia, the incidence of undiagnosed CAI in SIAD is unknown.Objective: To establish the incidence of CAI in SIAD.<p class="abs...

Acute hyponatraemia is a medical emergency with high mortality. Recent expert guidelines advocate treatment with intravenous boluses of 3% saline with the aim to reduce cerebral oedema more rapidly than traditional slow intravenous infusion, but there is a poor evidence base for this policy change. We retrospectively audited treatment of symptomatic hyponatraemia due to SIAD (n=57, age 22–76 year), comparing low dose (20 ml/h) and bolus infusion of 3% saline. Bol...