Endocrine Abstracts

A 22 year old man was referred to the endocrine unit at St Barts following an abnormal visual field test with his optician and subsequently with ophthalmology at Moorfields eye hospital. At presentation he was noted to be very tall (194 cm), with facial features of growth hormone excess. Despite starting puberty at the age of 12–13 he had experienced continued vertical growth - he was the tallest in his family and his parents had commented that he was continuing to grow, ...

A 51-year-old gentleman presented in June 2022 with pneumobilia, staph liver abscesses and rapidly conducted atrial fibrillation requiring ITU admission. He had a 2-year history of typical Cushingoid features and hypogonadism, 4 agent hypertension since 2012, fragility fractures, previous renal calculi, pulmonary emboli and diabetes. He had not been able to walk unaided for a year (was mobilising with crutches on admission). In retrospect, he had previously had a cortisol of 7...

Case History: A 69-year-old gentleman was admitted having lost consciousness. This episode was preceded by typical hypoglycaemic symptoms which, in retrospect, he had experienced for four decades with increasing frequency and severity over the past year. He was hypertensive. There was no family history of endocrinopathy or diabetes.Investigations: A supervised inpatient fast was undertaken along with cross-sectional and radio-isotope imaging.<p class...

A 47 year old Macedonian Personal Trainer presented with 4 days of vomiting, abdominal pain and profuse sweating. He admitted abusing anabolic steroids 20 years previously but never insulin. The presenting capillary blood glucose (CBG) was 1.7 mmol/L, blood pressure (BP) 182/106 mmHg, pulse 62 bpm. On examination, he was sweaty, pale and cold. Blood was drawn for measurement of insulin, C-peptide, glucose, cortisol and thyroid function tests. He was treated with 50% dextrose a...

Background: Endogenous Cushing’s syndrome (CS) in children remains a challenge to diagnose and exclude. 24-h urinary free cortisol (UFC) measurements are a convenient, non-invasive test for paediatric patients.Objective: To assess the screening accuracy of 24-h UFC measurements in paediatric patients referred to our centre for evaluation of possible CS.Methods: A retrospective review of children referred to our centre between ...

Background: Succinate dehydrogenase B (SDHB) associated disease has been characterised by the presence of extra-adrenal paragangliomas with a high rate of metastatic transformation. There is currently no consensus as to the appropriate surveillance regimes for these subjects. We present the surveillance data from a single UK institution with an SDHB surveillance regime which includes annual MR imaging of the abdomen, biennial imaging of the neck, thorax and pelvis and annual u...

Selective transsphenoidal adenomectomy remains the accepted first line treatment for Cushing’s disease (CD), until recently by microscopic (sublabial) transsphenoidal pituitary surgery. Endonasal transsphenoidal endoscopic surgery is emerging as a novel, less invasive treatment for pituitary adenomas with lower postoperative complications and morbidity. The safety of endoscopic surgery has been extensively reviewed in adult patients and is now considered best practice for...

Introduction: Bone mineral density (BMD) and fracture tendency are influenced by diet, activity, drugs, and hormones. Recent studies highlight an inverse relationship between serotonin and BMD, of uncertain mechanism.Purpose: We investigated the relationship between serotonin metabolites and BMD in patients with sporadic neuroendocrine tumours (NETs), with and without the carcinoid syndrome.Materials and methods: One-year prospecti...

Background/objective: Published data suggest that growth hormone replacement (GHR) may be safely given to patients with hypopituitarism consequent upon a pituitary/peri-pituitary tumour. However, to date, these series have included a preponderance of patients treated with external pituitary irradiation. We have performed a retrospective study to evaluate the recurrence rate in a group of patients with pituitary/peripituitary tumours treated with GHR.Meth...

Background: Radioactive iodine therapy (RAI) is established as a safe and effective treatment for adults with Grave’s disease. As thyrotoxicosis in children is rare, it is difficult to obtain high quality evidence about the safety and efficacy of RAI. We present data from our centre between 2007 and 2017.Methods: 20 paediatric patients with hyperthyroidism (16F), median age 15.7 years (range 10.8–19.3) had RAI in our centre either one or two do...