Endocrine Abstracts

Introduction: The super-super-obese category of patient (BMI >60) tend to respond poorly to conservative weight interventions. Bariatric surgery is therefore considered the best form of intervention. Only a few UK centres have expertise to manage patients with a BMI >100kg/m2 and careful counselling is essential as those standing to benefit the most from these procedures (through reduced risk of cardiovascular disease, diabetes and malignancy) also face the ...

Introduction: In this audit we explored the treatment and follow up of pre-2016 cases against the 2016 European Society of Endocrinology (ESE) guidelines on PPGL follow-up.Results: Demographics of the patients revealed 50% were male with median age (45±5), 82% of patients underwent surgery of which 73% were diagnosed with adrenal phaeochromocytomas & 27% with paragangliomas. Only 64% of surgical cases were followed up in clinic in the last year....

Introduction: We describe a patient with Fibrodysplasia ossificans progressiva (FOP) who developed an osteomyelitic neuropathic toe ulcer. This was treated effectively with conservative measures, but highlighted the need for multiprofessional working in managing patients with FOP.Case: The patient’s toe ulcer occurred in 2017 and was initially managed by community podiatry and orthopaedics. The patient received multiple courses of antibiotics for r...

Background: It is well recognised that the most frequent cause of mineralocorticoid induced hypertension is primary hyperaldosteronism. Excess 11-deoxycorticosterone (11-DOC), which is a precursor molecule for the production of aldosterone, may in rare cases be the cause of the mineralocorticoid induced hypertension in patients with normal or low aldosterone levels.Case: We describe a 70 year old female patient with a background of treated breast cancer ...

Introduction Adrenal myelolipomas are rare small benign tumours composed of mature fat and hemopoietic tissues, which can be associated with congenital adrenal hyperplasia (CAH). We report a rare case of massive bilateral adrenal myelolipomas.Case report A 48 year old gentleman with CAH diagnosed during childhood presented at a routine endocrine appointment. He had not regularly attended his appointments or taken his steroids f...

Introduction Adrenal myelolipomas are rare small benign tumours composed of mature fat and hemopoietic tissues, which can be associated with congenital adrenal hyperplasia (CAH). We report a rare case of massive bilateral adrenal myelolipomas.Case report A 48 year old gentleman with CAH diagnosed during childhood presented at a routine endocrine appointment. He had not regularly attended his appointments or taken his steroids f...

Background: There are over 650 liver transplants performed in the UK each year and about 5000 throughout Europe. After transplantation patients suffer from bone loss due to multiple factors. We present a unique case of severe Vitamin D deficiency resulting in life threatening hypocalcaemia following liver transplantation.Case: A 65-year-old Indian lady underwent an uncomplicated liver transplant, for hepatocellular carcinoma related to Hepatitis C. Pre a...

Aim: In light of recent publications - could a lower cortisol cut off value of ~350 nmol/l be used to safely rule out adrenal insufficiency (AI) compared to current local guideline cutoff value of either a baseline or 9am cortisol of 420 nmol/l? If so could this potentially help reduce the number of Co-syntropin stimulation tests (CST) performed?Background: Current local guidelines recommend a cortisol cut value of 420 nmol/l to rule out adrenal insuffic...

Introduction: Water deprivation testing (WDT) is considered the gold standard test in differentiating between craniogenic diabetes insipidus (DI), nephrogenic DI and primary polydipsia. However, it requires day case admission for monitoring of sodium and osmolality. Copeptin, derived from pre-provasopressin, is secreted in an equimolar amount with arginine vasopressin and has a potential role in facilitating the diagnosis of DI and reducing the need for WDT. Copeptin was gradu...

Background: Adrenocortical carcinoma (ACC) is a rare malignant tumour of the adrenal cortex with an incidence of 0.7-2.0 per million per year. The majority are steroid-producing with non-ACTH dependent hypercortisolism the most frequent biochemical abnormality. Around 10-15% of cases are picked up incidentally on abdominal imaging. Management of ACC during the covid-19 pandemic poses specific challenges. We present the case of a 69-year-old man who was found to have a massive ...