Endocrine Abstracts

Introduction: Post-surgical hypoparathyroidism (PoSH) is common after thyroidectomy. Most cases recover within 6 months, but several require long-term supplementation with calcium and activated vitamin D. When PoSH persists beyond 6 months, it is considered to be ‘long-term’ or ‘permanent’. However, few studies have demonstrated recovery beyond this time period.Aim: Aim of this study is to determine the frequency of late recovery in t...

Background: Traditional method in Sheffield involved preoperative admission and use of an intensive regimen. The pandemic led to the development and implementation of an outpatient-based protocol (SPROG - ‘Sheffield Peri-operative Rapid Optimisation in Graves’ disease (GD)’) for patients’ intolerant to thionamides and/or with uncontrolled disease requiring thyroidectomy. Control was achieved using sequential addition and dose-escalation of drugs such as Lug...

Background: Paragangliomas are extremely rare endocrine tumours and can cause diagnostic difficulty, especially with a coexistent metastatic malignancy.Case: A 78-year-old man with diagnosed metastatic melanoma underwent a PET scan for staging of the malignancy. It showed a left upper quadrant mass with multiple skeletal deposits and a lesion in the pituitary all with intense focal uptake. The mass was unusual for a metastatic lesion from melanoma althou...

Background: Papilledema and raised intracranial pressure has been reported frequently in patients with hypoparathyroidism but very rarely optic neuritis (1).Clinical case: We report a case of 63-year-old male who presented to ophthalmology with right-sided visual loss and a relative afferent pupillary defect. He was diagnosed with optic neuritis and underwent MRI brain which showed bilateral white matter changes with the possibility of demyelination. He ...

Background: The hypothalamic-pituitary-adrenal (HPA) axis can be suppressed by long-term exogenous glucocorticoids, resulting in tertiary adrenal insufficiency (AI). International expert consensus suggests that during weaning, prednisolone be converted to hydrocortisone to allow HPA axis reactivation(1). There is, however, little evidence to support this practice.Aim: To compare HPA axis recovery during treatment with prednisolone and immediat...

Background: The management of Primary hyperparathyroidism (PHPT) during pregnancy is challenging due to lack of robust guidelines. Various studies have suggested an increased risk of various maternal and foetal complications, however there is no clear consensus in the literature about medical treatment vs surgery during pregnancy. The aim of this study was to review the maternal and foetal outcomes of pregnant women treated for PHPT at a single tertiary care centre and compare...

Introduction & aimHypertonic saline (HTS) is an effective treatment for severe symptomatic hyponatraemia. European Society of Endocrinology (ESE) published guidelines to standardise HTS administration in 2014, however, evidence behind the guidelines is limited by virtue of being largely derived from small retrospective studies and expert opinion. The aim of this study was to evaluate the ’real-world’ safety and efficacy of these guidelines....

Background: Cut-offs for basal cortisol (early morning) have been determined to predict the 30-minute cortisol level post-synacthen, but not for determining when patients with suspected tertiary adrenal insufficiency (AI) are weaned off glucocorticoids.Aims: The aim of this study was to compare the predictive values of basal cortisol, basal ACTH and basal cortisol:ACTH ratio to determine appropriate thresholds to reduce ...

Background: Syncope and pre-syncope are well recognised symptoms of primary adrenal insufficiency (AI). Some guidelines(1) recommend screening for AI in all patients who present with symptoms of orthostatic intolerance. However, the incidence of AI in these patients is unknown.Aims: The aim of the study was to determine the incidence of AI in patients referred to a cardiac autonomic dysfunction clinic at a sin...

Background: Cranial Diabetes Insipidus (CDI) or Arginine-Vasopressin Deficiency (AVP-D) is a potentially life-threatening condition requiring treatment with desmopressin. Omission or delay in desmopressin can result in serious patient harm.Aims: Evaluation of desmopressin prescription/administration practice and implementation of an action plan to improve patient safety.Methods: Re...