Searchable abstracts of presentations at key conferences in endocrinology

ea0086p362 | Reproductive Endocrinology | SFEBES2022

Clinical utility of GnRH analogues in female androgen excess: diagnostic and therapeutic implications

Madden Doyle Lauren , Cussen Leanne , McDonnell Tara , O'Reilly Michael W

Rare causes of severe androgen excess (AE) can present a diagnostic challenge to endocrinologists. Imaging may not identify occult ovarian pathology, and the detection of adrenal nodular disease may be indicative of incidental pathology. GnRH analogues can be used both as a medical treatment and as a diagnostic utility to confirm ovarian source, particularly in women with a preferential elevation of serum testosterone (T). In this case series, we present three cases highlighti...

ea0074ncc1 | Highlighted Cases | SFENCC2021

Myxoedema Coma precipitated by Diabetic Ketoacidosis

Cussen Leanne , Kennedy Carmel , McDonnell David , Agha Amar

Section 1: Case History: We present the case of a 52-year-old found female found collapsed at home with a three-week history of polyuria, polydipsia and lassitude on a background of primary hypothyroidism and non-insulin-dependent diabetes. On examination, she was hypothermic at 32°C, hypotensive (blood pressure 90/60 mmHg), newly oliguric, and had a Glasgow coma scale (GCS) of 9/15. A diagnosis of severe diabetic ketoacidosis (DKA) was made on admission. <p class="ab...

ea0086p354 | Neuroendocrinology and Pituitary | SFEBES2022

Primary CNS lymphoma presenting with cranial diabetes insipidus – a case series

Madden Doyle Lauren , Cussen Leanne , McDonnell Tara , O'Reilly Michael W , Agha Amar

Primary CNS lymphoma (PCNSL) accounts for 0.85% - 2.0% of primary brain tumours. PCNSL arises in periventricular regions of the corpus callosum, with hypothalamic involvement less commonly. While cases have been reported in the literature, cranial diabetes insipidus (CDI) secondary to PCNSL is a rare phenomenon. We present this case series of three patients from our institution diagnosed with CDI and panhypopituitarism in the context of PCNSL.Cases: 1. 3...

ea0086p358 | Reproductive Endocrinology | SFEBES2022

The reproductive years: the experience of women attending routine diabetes care

McDonnell Tara , O'Connor Aisling , Cussen Leanne , Madden Doyle Lauren , Forde Hannah , Smith Diarmuid , O'Reilly Michael W.

Reproductive morbidity is increased in women with diabetes, including a higher prevalence of polycystic ovary syndrome, hypothalamic amenorrhoea and premature ovarian failure. Routine discussion of reproductive and menstrual dysfunction for women with diabetes remains a peripheral feature of clinical consultations. Here we aimed to determine women’s own reproductive care experience. We surveyed women of all ages attending routine diabetes care using a detailed clinical qu...

ea0090p676 | Pituitary and Neuroendocrinology | ECE2023

Hyperosmolar Hyperglycaemic State (HHS) and severe decompensated heart failure as presenting features of ectopic ACTH Syndrome

McDonnell David , Cussen Leanne , Martin-Grace Julie , Cotter Paul , Grogan Liam , Agha Amar

Ectopic ACTH syndrome is a rare condition occurring in five to ten percent of ACTH dependent hypercortisolism. We present the case of a fifty eight year old gentleman who presented with severe hyperosmolar hyperglycaemic state (blood glucose fifty seven mmol/l) and acute decompensated heart failure associated with elevated liver enzymes. Liver ultrasound followed by computed tomography of thorax abdomen and pelvis showed a lung tumour with liver metastases. Clinical suspicion ...

ea0091wd14 | Workshop D: Disorders of the adrenal gland | SFEEU2023

Life-threatening hypokalaemia heralding the diagnosis of metastatic Adrenocortical Cancer (ACC) with 11-deoxycortisol hypersecretion

McDonnell Tara , Leanne Cussen , Miller Clare , Moran Carla , Dugal Neil , Sherlock Mark , O'Reilly Michael

A 51 year old presented with headaches, fatigue and generalised weakness. She had a background history of hypertension diagnosed one year prior to presentation. Initial laboratory evaluation demonstrated life-threatening hypokalaemia, potassium 0.9mmol/l(R.I. 3.5-5.3). This profound hypokalaemia required ICU admission for replacement of potassium and monitoring. Management of subsequent fluid overload necessitated a brief period of hemofiltration. During the course of evaluati...

ea0091wg3 | Workshop G: Disorders of appetite and weight | SFEEU2023

Clinical utility of GnRH analogues in female androgen excess due to severe insulin resistance

Cussen Leanne , McDonnell Tara , Miller Clare , Madden Doyle Lauren , W O'Reilly Michael

Lipodystrophy represents a broad spectrum of disorders, subdivided depending on aetiology (congenital or acquired) or the extent of adipose tissue absence (generalised or partial). A lack of adipose tissue results in systemic insulin resistance and ectopic fat deposition, which predisposes patients to metabolic syndrome and associated conditions such as non-alcoholic fatty liver disease and diabetes mellitus. Additionally, severe hyperinsulinaemia can generate ovarian androgen...

ea0070ep49 | Adrenal and Cardiovascular Endocrinology | ECE2020

Ectopic ACTH syndrome presenting as pneumocystis pneumonia

Kennedy Carmel , Cussen Leanne , O’Reilly Michael , Newman Newman Christine

Ectopic adrenocorticotropic hormone (ACTH) syndrome occurs in about 5–10% of all patients with ACTH-dependent hypercortisolism. We present the case of a 35 year old gentleman who presented with a six month history of progressive 16 kg weight gain and breathlessness. Pulmonary imaging revealed bilateral infiltrates suspicious for Pneumocystis pneumonia (PCP). Physical examination was concerning for Cushing’s syndrome, with facial plethora, easy bruisability and broa...

ea0090oc11.2 | Oral Communications 11: Late Breaking | ECE2023

Machine learning-based steroid metabolome analysis reveals three distinct subtypes of polycystic ovary syndrome and implicates 11-oxygenated androgens as major drivers of metabolic risk

Melson Eka , Rocha Thais P. , Veen Roland J. , Abdi Lida , Mcdonnell Tara , Tandl Veronika , Hawley James M. , Wittemans Laura B.L. , Anthony Amarah V. , Gilligan Lorna C. , Shaheen Fozia , Kempegowda Punith , Gillett Caroline D.T , Cussen Leanne , Missbrenner Cornelia , Lajeunesse-Trempe Fannie , Gleeson Helena , Aled Rees D. , Robinson Lynne , Jayasena Channa , Randeva Harpal S. , Dimitriadis Georgios K. , Gomes Larissa , Sitch Alice J. , Vradi Eleni , Taylor Angela E. , O'Reilly Michael W. , Obermayer-Pietsch Barbara , Biehl Michael , Arlt Wiebke

Introduction: Polycystic ovary syndrome affects 10% of women and comes with a 2-3fold increased risk of type 2 diabetes, hypertension, and fatty liver disease. Androgen excess, a cardinal feature of PCOS, has been implicated as a major contributor to metabolic risk. Adrenal-derived 11-oxygenated androgens represent an important component of PCOS-related androgen excess and are preferentially activated in adipose tissue. We aimed to identify PCOS sub-types with distinct androge...