Searchable abstracts of presentations at key conferences in endocrinology

ea0013p45 | Clinical practice/governance and case reports | SFEBES2007

Di-George syndrome presenting as hypocalcaemia in adulthood

Hunter Steven , Johnston Philip , Morrison Patrick

A 29 year old female presented with a two year history of recurrent numbness and tingling in her hands. Trousseau’s sign was positive. Investigations confirmed hypocalcaemia with serum calcium 1.64 nmol/L (2.10–2.60), phosphate 1.23 nmol/L (0.80–1.55), alkaline phosphatase 82 U/L (35–120). Parathyroid hormone was inappropriately normal at 36 pg/ml (10–65), Vitamin D 78 nmol/L (50–75). Her mother reported a history of hypocalcaemia when she was two...

ea0091cb28 | Additional Cases | SFEEU2023

Thyroid function and Self Help

Bonanos Stathis , Mullan Karen , J Hunter Steven , Wallace Helen

A 60 year old nurse presented to the emergency department with palpitations, itchy skin, shortness of breath, diarrhoea, insomnia, weight loss and feeling hot /clammy. She felt her symptoms were in keeping with the menopause although she had been amenorrhoeic for six years. Thyroid function tests revealed fT4 73 pmol/land TSH <0.01 mIU/lhaving been normal six months previously. She was started on carbimazole 40 mg/day and was seen urgently in clinic. She reported to feelin...

ea0069p28 | Poster Presentations | SFENCC2020

A case of macroTSH masquerading as subclinical hypothyroidism

D'Arcy Robert , McDonnell Margaret , Spence Kirsty , Refetoff Samuel , Hunter Steven

Case history: A 47 year old male presented to his GP with non-specific symptoms of fatigue and weight gain. Thyroid function tests revealed elevated TSH (28.4 mU/l) with normal Free T4 (14.3 pmol/l). Anti-TPO antibodies were undetectable. A presumptive diagnosis of subclinical hypothyroidism was made and he was commenced on Levothyroxine which was titrated over 9 months to 150 mcg/d given a persistently elevated TSH. The patient was unable to tolerate this dose due to the deve...

ea0059ep42 | Clinical practice, governance &amp; case reports | SFEBES2018

2 cases of Pneumocystis Jirovecii Pneumonia occurring during treatment of Cushing’s Syndrome. Is there a case for prophylaxis of PJP in the treatment of severe hypercortisolism?

Hunter Amy , Hunter Steven , McCance David , Walsh Joseph

Pneumocystis jirovecii pneumonia (PJP) is well recognised in HIV infected and transplant recipient populations and prophylaxis is standard practice. PJP may also occur in rarer cases of immunodeficiency. We report 2 cases of Cushing’s syndrome complicated by PJP. Patient 1 was a 30 year old Indian male who presented with 2 weeks of bloody diarrhoea, abdominal pain and lethargy. He was cushingoid and investigations showed severe hypercortisolism (urinary cortisol >266,...

ea0031p84 | Clinical practice/governance and case reports | SFEBES2013

The challenges of a dopamine secreting paraganglioma

Lewis Anthony , Harper Roy , Hunter Steven , Mullan Karen

A 39-year-old female presented with an 18-month history of borderline hypertension, headaches, palpitations and some anxiety symptoms. Both parents also had hypertension. Blood pressure was 160/102 on no medications. She had a large single cafe au lait spot but no neurofibromata. Urinary dopamine levels were repeatedly elevated (5398–8653 nmol/24 h (n<3900)) with normal noradrenaline and adrenaline levels. Serum calcium was also elevated at 2.83 mmol/l (n...

ea0021p250 | Pituitary | SFEBES2009

TSH-secreting pituitary adenoma: potential benefits of pre-operative octreotide

Wallace Ian , Healy Estelle , Cooke Steve , Harper Roy , Hunter Steven

TSH-secreting pituitary adenomas are rare and the optimal investigation and management is uncertain.A 42-year-old lady presented with a three-month history of three stone weight loss, palpitations, heat intolerance and tremor. Her sister was being treated for Graves’ disease. Visual fields were intact.Thyroid function tests showed free T4 concentration 29.5 pmol/l (9.0–19.0) and TSH concentration 3.672 mU/l (0....

ea0015p81 | Clinical practice/governance and case reports | SFEBES2008

Nasal polyps: an unusual presentation of macroprolactinomas

Johnston Philip , Courtney Hamish , Hunter Steven , Mc Cance David

Intranasal presentations of pituitary tumours are rare. Management can be difficult and delayed due to their location and extension. Macroprolactinomas are uncommon and can often pursue an aggressive clinical course, including invasion into the nasopharynx.We describe three cases of prolactinomas that initially presented to the ENT Department as nasal polyps. Table 1 highlights their clinical features and response to treatment. Recurrence of nasal polyps...

ea0049ep1041 | Pituitary - Clinical | ECE2017

Idiopathic isolated acquired ACTH deficiency– a case series from the Irish National Pituitary Network

Hannon Anne marie , Smith Diarmuid , Sherlock Mark , Hunter Steven , Thompson Chris

Idiopathic Isolated ATCH deficiency (IIAD) is a rare cause of secondary adrenal insufficiency characterised by ACTH deficiency with otherwise intact pituitary function. Our objective was to describe the presentation, the autoimmune associations and diagnostic findings observed in IIAD. We present a case series of 19 cases of idiopathic Isolated ACTH deficiency which were identified from the National Pituitary Register in Ireland. A chart and biochemical review was performed to...

ea0044p7 | Adrenal and Steroids | SFEBES2016

Screening for Cushings syndrome: A comparison of available tests

McKeever Edward , McCance David R , Hunter Steven J , Courtney Hamish , Mullan Karen R , Graham Una M

Nocturnal salivary cortisol (NSC), urinary free cortisol (UFC) and overnight dexamethasone suppression testing (ODS) are recommended screening tests for Cushing’s syndrome (CS). Individual centers differ in their screening approach; UFC being the test of choice in Northern Ireland with ODS in patients with adrenal incidentalomas. NSC, which measures free cortisol, is not routinely used. The aims of this study were to 1. Evaluate the utility of NSC in the diagnosis of CS; ...

ea0059p018 | Adrenal and steroids | SFEBES2018

The role of plasma metanephrines and plasma catecholamines in the biochemical testing for Pheochromocytoma

Spence Kirsty , Hunter Steven , Brown Campbell , Thompson Paul , Mullan Karen , McDonnell Margaret

First line screening for pheochromocytoma, as recommend by Endocrine Society guidelines, is to determine plasma free or urinary fractionated metanephrines. We routinely offer the latter. Although negative results rule out pheochromocytoma, it is not uncommon to see borderline results which require further investigation. In this situation we have historically relied on the measurement of plasma catecholamines in the clonidine suppression test (CST). Plasma metanephrines, howeve...