Endocrine Abstracts

The usual management at our centre for patients awaiting phaeochromocytoma surgery involves pre-operative titration of alpha blockade with frequent clinic visits for blood pressure (BP) and heart rate (HR) monitoring. The COVID-19 pandemic restricted our ability to consult with patients frequently. To reduce infection risk, we incorporated virtual BP monitoring using a Microsoft Excel template coupled with regular remote consultations. We present a clinical case highlighting o...

Objective: This study aimed to characterise the relationship between immune checkpoint inhibitors (ICIs), which are commonly used to treat cancer, and thyroid dysfunction in terms of the proportions affected, timing of onset, sequalae and risk factors.Design: Retrospective cohort studyMethods: Patients with normal baseline thyroid function who received an ICI were included. Proport...

Pituitary metastases are reportedly uncommon. Here we report two cases illustrating metastases responding to systemic anticancer therapy (SACT). A 49-year-old woman with metastatic renal cell carcinoma treated with combination ipilimumab and nivolumab immunotherapy was referred for hypocortisolaemia (morning cortisol 74 nmol/l). Biochemical screening revealed an adrenocorticotropic hormone of 16ng/l (0-46), thyroid-stimulating-hormone 0.1mU/l (0.55-4.78), free thyroxine 7 pmol...

Approximately 15-20% of phaeochromocytomas and paragangliomas (PPGL) are metastatic. Metastatic spinal cord compression (MSCC) has been reported infrequently. We present three cases of MSCC secondary to metastatic PPGLs. MSCC can occur in patients with PPGLs and should be considered in patients with either spinal symptoms or spinal metastases on imaging. Our series has shown radiotherapy followed by therapeutic MIBG to be effective in treating spinal metastases. Each case shou...

Introduction: Immunotherapy has transformed the outcomes of various cancers. Monoclonal antibodies against cytotoxic T lymphocyte antigen 4 (CTLA4), programmed cell death 1 (PD1) and its ligand, PDL1 target mainly T cells, unleashing the immune system against tumour cells. Immune checkpoint inhibitor therapy results in a variety of immune related adverse events, including various endocrinopathies. Thyroid disorders, pituitary disorders are relatively more common compared to pr...

Background: Immunotherapy mediated adrenocorticotrpic hormone (ACTH) deficiency is an important toxicity related to immune-checkpoint inhibitors (ICPi) potentially resulting in significant morbidity. Early diagnosis and optimal management are essential and frequently necessitate inpatient hospital treatment. We have previously reported an ambulatory management pathway for ICPi-induced ACTH deficiency in 4 patients. We sought to report the outcomes of this pathway in a larger c...

Phaeochromocytoma-driven Ectopic ACTH Syndrome (EAS) is rare. We report the case of a 31-year-old female, who presented with abdominal pain and vomiting. She had clinical features of severe Cushing’s syndrome (proximal myopathy, bruising, refractory hypertension and acute confusion). Admission investigations revealed hypokalaemia (2.1mmol/l [3.5-5.5mmol/l]) and a 4.5cm left adrenal lesion with a ’bulky’ right adrenal on CT abdomen. She was diagnosed with hyperte...