Searchable abstracts of presentations at key conferences in endocrinology

ea0086p158 | Adrenal and Cardiovascular | SFEBES2022

Salivary dexamethasone and 11-dehydrodexamethasone analysis post overnight dexamethasone suppression test

Marshall David , Keevil Brian , Issa Basil

Background: The 1 mg overnight dexamethasone suppression test (ONDST) is recommended as a first-line test for the investigation of Cushing Syndrome. Measurement of dexamethasone alongside cortisol in a 9am serum sample has been credited with improving diagnostic sensitivity of the test. Previous studies have also looked at the utility of salivary dexamethasone and have observed poor correlation with serum dexamethasone. Herein we introduce the concept of measuring 11-dehydrode...

ea0038p173 | Neoplasia, cancer and late effects | SFEBES2015

A management dilemma – emergency treatment of primary hyperparathyroidism in suspected but unconfirmed multiple endocrine neoplasia type 1

Khurana Ramneet , Gandhi Ashu , Issa Basil

A 27 year old male patient with severe cardiomyopathy secondary to Epirubicin chemotherapy for rhabdomyosarcoma in infancy was noted to be hypercalcaemic during the course of admission for severe inotrope dependant congestive cardiac failure. Biochemical investigations confirmed a diagnosis of primary hyperparathyroidism (corrected Calcium 3.10 mmol/l, PTH 22 pmol/l, Vitamin D 77 nmol/l).His brother had undergone trans-sphenoidal pituitary surgery for ac...

ea0082wd6 | Workshop D: Disorders of the adrenal gland | SFEEU2022

Acute presentations of 4 patients with spontaneous adrenal haemorrhage

Ganawa Shawg , Ensah Grace , Keevil Brian , Issa Basil

: We report on 4 patients who acutely presented to our unit and diagnosed with adrenal haemorrhage.Case 1: A 72 year old man presented with generalised abdominal pain, fever and raised CRP a week after hip replacement surgery. CT abdomen showed non-enhancing bilateral adrenal lesions consistent with adrenal haemorrhage. He was taking Apixaban for DVT following hip replacement. SST was performed which confirmed suboptimal cortisol response. Hence, Treated...

ea0059p026 | Adrenal and steroids | SFEBES2018

Evaluation of glucocorticoid secretion in an adrenal incidentaloma cohort

Mason Oliver , Hanna Fahmy , Keevil Brian , Ensah Grace , Issa Basil

Background: Adrenal incidentalomas (AI) are being seen frequently in endocrine clinics due to increased cross-sectional imaging with a prevalence of 4% (7% in patients >70 years) of abdominal CT scans. The majority of these tumours are benign and non-functional, but identifying malignancy and functionality is important. Excess cortisol production is the commonest endocrinopathy associated with AI, with a reported prevalence of ~10%. The overnight 1 mg dexamethasone suppres...

ea0035p45 | Adrenal cortex | ECE2014

Markedly elevated glucocorticoids and their metabolites in an unusual case of Cushing's syndrome secondary to ectopic ACTH production from a thymic carcinoid

Kyriacou Angelos , Stepien Karolina , Cooksley Timothy , Keevil Brian , Issa Basil

A 51-year-old obese lady was admitted with multiple cerebral, pulmonary and intra-abdominal abscesses. She was referred to the endocrine team because of newly-diagnosed type 2 diabetes mellitus. The combination of apparent immunosuppression, obesity, diabetes mellitus, hypertension, hypokalaemia, osteoporotic fractures and bilateral shoulder avascular necrosis (BSAN) led to a clinical diagnosis of CushingÂ’s syndrome (CS); this was biochemically confirmed as follows: non-s...

ea0034p89 | Clinical practice/governance and case reports | SFEBES2014

Low dose tolvpatan (7.5 mg) is effective in the management of SIADH in oncology patients (results from a retrospective audit at The Christie Hospital and Wythenshawe Pulmonary Oncology Unit)

King Jennifer , Kyriacou Angelos , Issa Basil , Taylor Paul , Higham Claire

Tolvaptan (a selective V2 receptor antagonist) is licensed for the inpatient management of SIADH induced hyponatraemia, a common complication in patients with malignancy. Licensed daily doses start at 15 mg but there is evidence that some patients have a rise in serum sodium (Na) of >12 mmol/l per 24 h in response to this. Lower initial doses (7.5 mg) may therefore be appropriate1,2.Methods: A retrospective case note audit was performed. T...

ea0055wh1 | Workshop H: Miscellaneous endocrine and metabolic disorders | SFEEU2018

A daughter’s diagnosis

Manohar Rao Balmuri Laxmi , Morris Lauren , Mumby Clare , Beynon Jennifer , Issa Basil

Case: An 89 year old gentleman was admitted to hospital following a collapse at home. His capillary blood glucose was found to be 1.4 mmol/l by the paramedics. The patient had experienced multiple collapses at home in the preceding 2 weeks. Each time, he had been found to be hypoglycaemic but treated and discharged from A&E. He complained of reduced appetite, weight loss and change in bowel habit. The patientÂ’s past medical history included a large fibroma of the left...

ea0035p455 | Diabetes complications | ECE2014

The correlation of foetal ultrasound and HbA1c with birth weight in women with gestational diabetes

Stepien Karolina , Rambihar Sophie , Leigh-Atkins Sue , Okinoye Gbemisola , Kyriacou Angelos , Whiteside Sigrid , Issa Basil

Background: It is estimated that gestational diabetes (GDM) accounts for 87.5% of all diabetes cases in pregnancy and is associated with worse pregnancy outcomes. Macrosomia is one of the main complications of GDM and antenatal management strategies are directed at ensuring normal foetal growth. Ultrasonography is a useful tool for estimating foetal size, but there is little data in the literature correlating foetal abdominal circumference (AC) and birth weight in GDM. Further...

ea0070oc1.5 | Adrenal and Cardiovascular Endocrinology | ECE2020

The utility of salivary cortisol and cortisone measurement in the assessment of cortisol secretion in adrenal incidentalomas

Issa Basil , Keevil Brian , Graham Neethu , Ensah Grace , Belcher John , Fryer Anthony , Hanna Fahmy

Backgound: Adrenal incidentalomas (AI) are lesions that are incidentally identified while scanning for other conditions. The European Society of Endocrinology guidelines recommend that all patients with AI should undergo an overnight dexamethasone suppression test (ONDST) for the evaluation of autonomous cortisol secretion as defined by failure of suppression of cortisol to < 50 nmol/l. The reported prevalence of this is high (50% of patients in a recent publication) and m...