Endocrine Abstracts

Radioactive iodine is a common and effective treatment for hyperthyroidism. Post radio-iodine hypothyroidism is a frequent complication occurring in ~80% of radioiodine treated patients. This can be diagnosed clinically (by monitoring free T4 and TSH levels) but, in our centre, a 123I uptake scan 6 weeks after therapy is sometimes used to help predict the likelihood of future hypothyroidism. In these situations, thyroxine therapy can be started if radioio...

Introduction: Measurement of microRNA (miRNA) in aldosterone-producing adenoma (APA) tissue from primary aldosteronism (PA) patients show levels of the miR24-1 cluster miRNAs (i.e. miRNAs 24-1, 27b and 23b) are significantly reduced relative to normal adrenal tissue. Our previous studies also show that miRNA-24 directly targets CYP11B2 (aldosterone synthase) gene expression. Circulating miRNAs released into the bloodstream may be diagnostic biomarkers or signalling mo...

Objective: Incidentally discovered adrenal masses (‘incidentalomas’) are found in 2% of the population. Adrenalectomy is necessary only in a small proportion of such subjects as outlined by the relevant ESE/ENSAT guideline1. However, uncertainty exists over the need for removal of lesions between 4 and 6 cm and those with low lipid content on CT scanning (found in 20% of benign adenomas). Our centre tends to offer surgery for all adenomas >4 cm.<p ...

Aim: The short Synacthen test (SST) is an established test used to assess the hypothalamic-pituitary-adrenal axis. There remains debate whether a 30 minute or 60 minute cortisol sample has diagnostic superiority. Currently at the Queen Elizabeth University Hospital, Glasgow all tests arranged by endocrinology are performed by endocrine nurse specialists who utilise a 0 and 30 minute cortisol protocol. Performing a further 60 minute sample requires more nursing time and space r...

Phaeochromocytomas (Phaeo) and paragangliomas (PGL) are rare catecholamine producing tumours. It can be difficult to predict their malignant potential and patients can sometimes present with metastatic disease many years after their original diagnosis (1). Therefore, we offer a single dose of adjuvant 131I-Metaiodobenzylguanidine (131I-MIBG) to subjects felt to be at higher risk of local recurrence (demonstration of capsular or vascular invasion on pathol...

A 64-year-old man (HM) was admitted to our local hospital with transient dysarthria and right hemiparesis; formal blood glucose was 2.2 mmol/l on admission. During his in-patient stay, he had frequent episodes of hypoglycaemia. Further questioning revealed a 4 week history of recurring dizzy spells which improved on eating.Cerebral imaging and adrenal function were normal and so the patient underwent further investigations (summarised below) which confir...

Aim: In chronic kidney disease (CKD) elevated aldosterone (Aldo) levels are a poor prognostic indicator, particularly in the context of a high dietary sodium intake, through unclear mechanisms. Blockade of the mineralocorticoid receptor (MR) improves surrogate patient outcomes. We hypothesised that regulation of aldosterone biosynthesis is disordered in CKD and aimed to compare this in a cohort of patients with CKD with subjects with essential hypertension (EH).<p class="a...

Context: Phaeochromocytomas are rare, but potentially fatal, neoplasms. The diagnosis and localization of phaeochromocytoma can be challenging and recently there has been some debate regarding the role for adrenal venous sampling (AVS). The utility of AVS in this setting is hampered by a lack of normative value data for adrenal vein catecholamine concentrations and the reliability of lateralization ratios. We sought to address these concerns by analyzing AVS catecholamine conc...

Aldosterone is key in the development of hypertension. We have shown that a SNP (−344T) in the 5’ regulatory region (UTR) of the gene encoding aldosterone synthase (CYP11B2) was associated with aldosterone excess and high blood pressure. However, the most robust phenotype is altered adrenal 11-hydroxylation efficiency (deoxycortisol to cortisol); a step carried out by 11β-hydroxylase, encoded by the adjacent gene, CYP11B1. We proposed that the effects of CYP11B...

Aim: Increasing left ventricular mass index (LVMI) is associated with a poor prognosis in patients with chronic kidney disease (CKD). Blockade of the mineralocorticoid receptor (MR) in CKD leads to improvement in proteinuria and LV mass. However, the MR can be activated by aldosterone, cortisol and deoxycorticosterone (DOC) and their relative contribution to adverse events in CKD is unclear. We aimed to assess the correlation between mineralocorticoid excretion and LVMI in pat...