Endocrine Abstracts

The recently published Endocrine Society Clinical Practice guideline on phaeochomocytoma and paraganglioma (PPGL) recommends measuring plasma metanephrines (PMets) with patients in the supine position after an overnight fast and using appropriately defined reference intervals.1 Studies have shown higher diagnostic sensitivities using the latter pretesting criteria.2 However, this testing protocol is resource intensive and arguably impractical in routine c...

Primary hyperaldosteronism (PHA) prevails in up to 20% of individuals with essential hypertension, but often presents a diagnostic challenge due to difficulty in interpreting the aldosterone renin ratio (ARR) largely due to anti-hypertensive medication interference. Interpretation of the ARR in the context of beta blockers presents a particular challenge and may produce false positive results due to renin suppression. We investigated the effects of beta blocker withdrawal on A...

A 83-year-old lady presented to hospital with a one week history of malaise, dyspnoea and chest pain. Her admission bloods revealed a markedly elevated calcium of 4.16 mmol/l. Further investigations revealed a PTH of >5000 ng/l. Clinically the patient had poor dentition which had developed over the past 3 years and a history of episodic abdominal pain and constipation. For investigation of primary hyperparathyroidism, she had an ultrasound neck, which revealed an enlarged ...

Raised body mass index (BMI) is seen in 95% of PCOS patients, which is characterised by hyperandrogenaemia, both clinically and biochemically. Weight loss, using calorie restricted diets, have previously been successful in improving androgen profiles and also restoring fertility in obese PCOS patients. A CB1 cannabinoid receptor antagonist, rimonabant is effective in achieving weight loss in subjects with a BMI >27 kg/m.This study aimed to...

IntroductionAdrenocortical Carcinoma (ACC) is a rare aggressive cancer which carries a poor prognosis. Adjuvant mitotane improves survival but is limited by poor response rates and resistance following tumour recurrence. Mitotane’s efficacy has been attributed to intracellular accumulation of toxic free cholesterol (FC) predominantly through inhibition of cholesterol storage through SOAT1. Yet SOAT1 specific inhibitors demonstrate inferior efficacy ...

Introduction: Primary Aldosteronism is the most common cause of secondary hypertension. First-line treatment; adrenalectomy resects adrenal nodules and adjacent normal tissue, limiting suitability to those who present with unilateral disease. Use of thermal ablation represents an emerging approach as a possible minimally invasive therapy for unilateral and bilateral disease, to target and disrupt hypersecreting aldosterone producing adenomas, while preserving adjacent normal a...

Background: Primary aldosteronism (PA) is responsible for 5-10% of all cases of HTN. The current gold standard test for determining the side of aldosterone hypersecretion is adrenal vein sampling (AVS). 11C-Metomidate PET/CT (METO-PET) has recently emerged as a potential non-invasive alternative to AVS. As 11C-Metomidate is concentrated within ‘hyperfunctioning’ nodules, METO-PET potentially not only identifies the side, but the exact site of al...

Primary aldosteronism (PA) arises from one or both adrenal glands and is a common cause of secondary hypertension accounting for approximately 5-12% of all hypertension. Current therapy involves mineralocorticoid receptor antagonists for bilateral disease (60%) or adrenalectomy for unilateral disease (30%). We investigate treatment planning of percutaneous adrenal ablation as an alternative definitive therapeutic modality for unilateral and bilateral disease. The main objectiv...

Rationale: The Aldosterone:Renin ratio (ARR) is commonly used for patients fulfilling screening criteria for primary hyperaldosteronism (PA), followed by confirmatory testing. Reference intervals for interpretation of the ARR vary in accordance with local population and assay 1. While ARR provides high sensitivity for PA, this is compromised by low specificity, further compounded by medication interference. However, additional variables may improve the specificity of ARR as a ...

To minimise damage to surrounding tissues, targeted delivery of therapeutics to the tumour is highly desirable, and the development of nanotechnology has shown promising results. Magnetic iron oxide nanoparticles (MIONPs) have been gaining traction over the years for applications such as drug delivery, molecular imaging and delivering hyperthermia for treatment of various cancers (1). MIONPs have great therapeutic potential as they can be produced in various sizes and shapes, ...