Endocrine Abstracts

The financial markets represent the largest and most intense competitive forum ever constructed. Here, according to classical economic theory, competition drives optimal allocation of capital to projects with the highest returns, thereby promoting global prosperity. However, financial markets can be volatile, cycling between ‘bull’ and ‘bear’ states, and threatening the stability of the global economy.Bull markets can morph into bubbl...

The financial markets represent the largest and most intense competitive forum ever constructed. Here, according to classical economic theory, competition drives optimal allocation of capital to projects with the highest returns, thereby promoting global prosperity. However, financial markets can be volatile, cycling between ‘bull’ and ‘bear’ states, and threatening the stability of the global economy.Bull markets can morph into bubbl...

Background: Thyrotropinomas (TSHomas) have traditionally been considered a rare, albeit important cause of thyrotoxicosis. However, a recent report suggests their prevalence may be 2–3 times higher than previously suspected. In addition, although early case series described a predominance of invasive macroadenomas, recent findings (including in our own cohort of 40 patients) confirm that microadenomas are being increasingly diagnosed, and the clinical/biochemical phenotyp...

Accurate diagnosis of thyroid dysfunction is dependent on understanding hypothalamic–pituitary–thyroid (HPT) axis physiology and the pathophysiology that can affect this classical endocrine feedback loop. Even minor perturbations of thyroid status, which may be imperceptible to the patient and clinician, can significantly alter the relationship between circulating thyroid hormone (TH) levels and pituitary TSH such is the finely-tuned nature of the axis.<p class="...

Although overt thyroid disease is easily recognised, lesser disturbances of thyroid function can prove difficult to diagnose and be mimicked by other endocrine and non-endocrine disorders. Establishing the correct diagnosis depends on accurate interpretation of thyroid function tests (TFTs), which is usually straightforward; however, in a minority of situations, the results of FT4, FT3 and TSH measurement either do not ‘fit’ with the clinical picture and/or appear di...

Case history: A 59 year old Afro-Carribbean male with a 25 year history of cardiac enlargement and hypertension, on multiple anti-hypertensives, presented with increasing breathlessness and several years of markedly reduced exercise tolerance. He was intolerant of spironolactone and eplerenone. His past medical history included hypertersion, obstructive sleep apnoea, Steven-Johnson syndrome secondary to allopurinol, thyrotoxicosis treated with radio-active iodine, monoclonal g...

We report a case of malignant hemangiopericytoma in sellar region in a 73-year-old lady who initially presented with symptomatic hyponatraemia. She was found to have hypocortisolism on short synacthen test. She was treated with hydrocortisone and was found to have secondary hypothyroidism. Her gonadotropin levels were commensurate with menopause, prolactin levels were normal and there was no suggestion of diabetes insipidus. Initial pituitary magnetic resonance imaging (MRI) w...

Background/aims/method: Evaluation/management of adrenal incidentalomas (AI) is an increasingly prevalent challenge. CT/MRI characteristics may be useful in determining whether a lesion is a benign adenoma and forthcoming ESE-ENSAT guidance suggests a role for 18F-FDG-PET/CT in distinguishing benign vs malignant lesions. We have previously demonstrated the utility of 11C-metomidate (MTO), which binds CYP11B1/B2, in localising aldosterone-producing adenoma...

TSHoma is rare, with an incidence of 1 per million, and <1% of all pituitary tumours. We reported a case involving a 49-year-old female who was first referred to our endocrine unit in 2006 with excessive lethargy and abnormal TFT’s. She was thought to have thyroid hormone resistance for several years until 2015 when she reported having persistent symptoms and further investigation suggested an alternative diagnosis.Results: Ft4=41.6 pmol/l, TSH=...

Background: Primary aldosteronism (PA) accounts for 5–10% of all patients with hypertension, and an even greater proportion of those with refractory hypertension. Accurate assessment of PA is important both for rationalisation of medical therapy and to identify those patients with unilateral disease who may benefit from surgery. Single timepoint testing may miss patients with intermittent (‘cyclical/periodic’) disease, a phenomenon seen in other endocrine hypers...