Endocrine Abstracts

Objective: The NHS long term plan aims to identify 25% of the Familial Hypercholesterolaemia (FH) patients in England by 2025. This study aimed to identify patients with FH, assess their classification according to the Dutch Lipid Clinic Network (DLCN) criteria, and evaluate treatment outcomes.Methods: We conducted a retrospective analysis of patients referred for assessment of possible FH who went on to have genetic tes...

We present three cases of ACTH-dependent Cushing’s syndrome, successfully managed with osilodrostat.Case 1: A 42-year-old woman diagnosed with ACTH-dependent Cushing’s disease was initially treated with osilodrostat dose-titration approach, as MRI of the pituitary did not identify a clear surgical target. By week five, serum cortisol levels fully normalised. Salivary and 24 hr urinary free cortisol (UFC) normalised on a mainten...

Case history: A 62-year-old lady with no significant past medical history presented early February 2021 with a week history of epigastric pain, tiredness and poor oral intake, 5 days following her first dose of AstraZeneca Covid-19 vaccine. She was cardiovascularly stable but generalised abdominal tenderness was noted. There was no history of hypertension, hypokalaemia or symptoms consistent with phaeochromocytoma.Investigations: Admission bloods reveale...

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...

Case history: A 73-year-old gentleman was admitted for evaluation of recurrent hypoglycaemia. He has had type 1 diabetes mellitus for 60 years, which was well controlled on a basal-bolus regime with carbohydrate counting. He had frequent hypoglycaemic episodes for 5 months despite drastic reduction in insulin dosage. His insulin was completely stopped on admission. He did not develop ketosis and continued to have hypoglycaemia. He did not have end-organ complications from T1DM...

Case history: A 41-year-old lady referred to diabetes clinic due to chronic diarrhoea on Metformin and for consideration of any injectable treatment. HbA1c was 41 and BMI is 35. In 2007, OGTT during pregnancy showed fasting glucose of 4.1 mmol/l and 2 h glucose of 7.8 mmol/l. In 2013 her fasting glucose was 7.5 and HbA1c was elevated at 53 mmol/mol. Since July 2013 she has been diagnosed as type 2 DM and started on Metformin. In October 2013 HbA1c fell to 49. Over the succeedi...

Introduction: Primary Hypothyroidism is a commonly encountered endocrine disorder and can be associated with pericardial effusion and cardiac tamponade in severe cases. Early detection of Hypothyroidism is key since it is a potentially treatable and reversible cause of pericardial effusions.Case Presentation: A 53-year-old female was admitted following a fall. Clinical history was remarkable with symptoms of persistent t...

Aim: To determine the current practice of radioiodine dose treatment provided in Hull and East Yorkshire NHS Trust, in line with the recommended guidelines of the Royal College of Physicians and published data.Methods: The medical records of the patients who received more than one dose of radioactive iodine for the treatment of thyrotoxicosis in Hull and East Yorkshire NHS Trust between 2006 and 2018 were reviewed retrospectively. The level of the bioche...

Background: We have seen an increased referrals to endocrinology because of adrenal lesions that are discovered on imaging performed for other clinical indications. This is largely driven by the increased use of, technological advancement in imaging modalities, and increasing prevalence of chronic disease. We performed an audit to determine the incidence of adrenal incidentalomas at a large general hospital and to assess management of adrenal incidentalomas in relation to the ...

Introduction: Adrenal Venous Sampling (AVS) is considered the gold standard to identify surgically treatable primary aldosteronism (PA) subtypes. Current guidelines suggest using plasma cortisol concentrations to confirm successful adrenal vein (AV) cannulation and lateralisation, but cortisol co-secretion by adrenal adenomas can lead to diagnostic misinterpretation. Plasma metanephrines (MN) have a half-life of 3 to 6 min and are not affected by cortisol co-secretion, and the...