Endocrine Abstracts

A 29 year old woman with multiple sclerosis and no history of thyroid dysfunction was referred to endocrinology with T3 thyrotoxicosis (TSH <0.01 mU/l, fT4 20.7 pmol/l, T3 2.9 nmol/l). She had received monoclonal alemtuzumab therapy 9 months prior. This hyperthyroid phase was short lived and in the absence of anti-thyroid medication developed symptomatic hypothyroidism within 2 months of referral (TSH 52.9 mU/l, T4 <5 pmol/l, T3 0.8 nmol/l). Thyroid receptor antibodies...

Background: Evidence suggests sex-specific differences in the development and progression of diabetic nephropathy (DN). Men and women have been shown to respond differently to certain therapies and epidemiological data suggest underuse of statins and renin-angiotensin system (RAS) blocking agents in women. We evaluated our local practice to identify differences in clinical characteristics and prescribing between men and women with DN.Methods: Clinical da...

Spindle Cell Oncocytoma (SCO) is a neoplasm of the adenohypophysis, often pre-operatively misdiagnosed as pituitary macroadenoma due to its rarity. First described in 2002, 28 cases have been described. It is a benign tumour manifesting in adults with no sex predilection, classified as WHO Grade I. A 71-year-old woman presented with bitemporal hemianopia, secondary hypoadrenalism, hypothyroidism and hypogonadotrophic hypogonadism. Imaging in October 2017 confirmed a 18.0×...

Primary adrenal lymphoma is a rare phenomenon with a male preponderance. There is bilateral gland involvement in two thirds of cases. Histology usually reveals an aggressive diffuse large B-cell subtype. Adrenal insufficiency is a recognised complication. We present a 62 year old man with a 4 month history of weight loss, night sweats and malaise. Clinical examination revealed right renal angle tenderness with no palpable lymphadenopathy. Inflammatory markers were raised with ...

Primary aldosteronism (PA) accounts for up to 15% of cases of hypertension, and associates with increased cardiovascular morbidity. Specific treatment options include mineralocorticoid antagonists or adrenalectomy; the latter offers cure although reported rates vary between 20–60%. The role of adrenal vein sampling (AVS) in diagnosing PA remains controversial. By reviewing casenotes of PA patients treated surgically and comparing with matched medically managed PA patients...

Background: There are differences in the development of diabetic nephropathy (DN) between men and women but the underlying molecular mechanisms are unknown. The urinary proteome may contain sex-specific biomarkers and thereby identify differentially regulated pathways to DN in men and women.Method: Urine samples were obtained from 157 patients with type 2 diabetes (age, 61 (29–71) years; 120 men and 37 women), preserved renal function (eGFR, 88 &#17...

Hypoglycaemia is a common and potentially life threatening presentation to Emergency Departments across the UK.It is often a result of medications for treatment of diabetes but other differentials include rarer reactive and fasting causes.This case report describes a 69 year old man who initially presented with right upper quadrant pain and weight loss which then lead to a diagnosis of inoperable hepatic sarcoma. He later presented with hypoglycaemia and Whipples triad in the ...

Background: Aldosterone levels are elevated in normal pregnancy but fall despite volume contraction in preeclampsia. Vascular endothelial growth factor (VEGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) have been implicated in this phenomenon in vitro and in animal work. Low placental growth factor (PlGF), which is closely linked to VEGF signalling, identifies women at risk of preeclampsia between 20 and 35 weeks gestation. We aimed to examine these relationships ...