Endocrine Abstracts

Ectopic Cushing’s syndrome is a rare condition accounting for 10–20% of all cases of ACTH-dependent Cushing. Neuroendocrine tumours (NETs), mainly bronchial carcinoids and small cell lung cancer, are the most frequent causes of ectopic ACTH secretion(1). Here we report two challenging cases with long duration of surveillance and monitoring.Case 1: A 42-year-old lady with a florid Cushing syndrome underwent bilateral adrenalectomy in 2002. An IP...

Although NICE guidelines recommend that radioiodine is the first-line treatment for Graves disease, carbimazole is often used initially to get control of the hyperthyroidism. This patient was exquisitely sensitive to carbimazole initially, and despite initial recurrence, he cannot be treated with radioiodine as he now has intermittent hypothyroidism.Case: A 42-year-old male was diagnosed with Grave’s disease and initially treated fo...

Aim: This is a retrospective study of imaging with adrenal incidentalomas at our DGH to assess clinical practice. Their management was followed and compared with the European Society of Endocrinology (ESE) Clinical Practice Guidelines 2016 for management of adrenal incidentalomas. The aim was to improve clinical service by developing a local management pathway.Materials and Methods: Data was collected for two years from 2018 to 2019 which included all im...

Section 1: Case: A 42-year-old woman developed central chest pain four hours after undergoing right mastectomy for intraductal breast carcinoma. Serial blood pressures were recorded as significantly elevated, up to 240/130mmHg. There was no history of new-onset headaches, palpitations, anxiety, hirsutism, change in weight or easy bruising. She had no other significant past medical history or family history. Section 2: Investigations : An electrocardiogra...

When patients with type 1 diabetes present with hyponatremia, Addison’s is an important condition to exclude. It is however important to consider other causes, and a trial of hydrocortisone is not part of the diagnostic test for adrenal failure. A 43-year-old lady, with a background of Type 1 Diabetes and depression, presented unwell with hyponatremia. Her basal cortisol was low 162 nmol/l along with an ACTH 16.2 ng/l. A short synacthen test (SST) revealed a baseline cort...

Bilateral adrenal haemorrhage is an uncommon but life-threatening condition which may result from trauma, sepsis, coagulopathy, underlying tumour or autoimmune conditions. We present a 62-year-old female with a history of well controlled hypertension and asthma who was admitted with sudden onset epigastric pain and suspected cholecystitis. She received her first dose of Astrazeneca (AZ) Covid-19 vaccine seven days prior to onset of symptoms. Her systolic blood pressure was mor...

Hypoglycaemia is a common side effect of insulin treatment in patients with type 1 diabetes mellitus (T1DM). A 16-year old girl with T1DM presented with a recurrent hypoglycaemia, despite insulin dose reduction. Differential diagnosis included: overdose of insulin, Addison’s disease, hyperthyroidism, insulinoma and anti-insulin antibodies. She was admitted to the hospital for observation and investigations. She had a low random cortisol level, leading us to start steroids...

We present a case of a young female, who was diagnosed with Graves’ thyrotoxicosis in 2019 with very high TSH Receptor antibody. She had a goitre and mild thyroid ophthalmopathy and was commenced on carbimazole. She was followed up in the Endocrine Clinic and carbimazole was titrated according to the clinical and biochemical picture. Her past medical history included epilepsy, generalised anxiety, and emotionally unstable personality disorder. She had difficult social cir...