Searchable abstracts of presentations at key conferences in endocrinology

ea0013s45 | Management of endocrine disorders in pregnancy: the mother and the child | SFEBES2007

Hyperglycaemia in pregnancy

McCance David

Some 50 years on from the originally published description of gestational diabetes mellitus, debates continues as to the significance of minor degrees of glucose intolerance for maternal/fetal outcome. Confusion has been compounded by different diagnostic practices and the likelihood that there is a continuum of risk. A fundamental lack of robust evidence is reflected in the lack of consensus among published guidelines. The picture has been further complicated by the current s...

ea0044oc6.4 | Pregnancy and Reproductive Health | SFEBES2016

Iodine nutritional status among pregnant women and their offspring in Northern Ireland (NI)

McMullan Paul , Hamill Lesley , McCance David , Woodside Jayne , Mullan Karen

Background: A re-emergence of mild iodine deficiency in the United Kingdom (UK) has been reported. A recent UK study suggested a dose dependent relationship between mild maternal deficiency and a number of childhood cognitive scores. The World Health Organisation defines sufficiency in a population as a median urinary iodine concentration (UIC) of ≥100 μg/l in non-pregnant women and infants and ≥150 μg/l during pregnancy. It also recommends a daily intake...

ea0059ep42 | Clinical practice, governance & 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,...

ea0037ep1094 | Endocrine tumours | ECE2015

Plasma chromogranin A and chromogranin B concentrations in untreated patients with mid gut carcinoid and their biochemical response to octreotide

Armstrong Lee , Rea Teresa , Johnston Brian , McCance David

We measured chromogranin A (CgA) and chromogranin B (CgB) in 36 patients, recently confirmed to have a midgut carcinoid tumour (MGC), prior to the commencement of octreotide treatment. Blood samples were taken before and after a bolus injection of 50 μg octreotide. There were 21 males, 15 females, age range 28–76 median 61 years.Basal CgA, expressed as times the upper limit of normal (ULN) ranged from 333.3 to 0.5 ULN. Basal CgB ranged from 33....

ea0028p181 | Obesity, diabetes, metabolism and cardiovascular | SFEBES2012

Endothelial function, the renin-angiotensin-aldosterone axis (RAAS) and hypertension: the therapeutic role of potassium supplementation

Graham Una , McCance David , Young Ian , Mullan Karen

There is limited evidence on the effect of potassium (K+) supplementation on endothelial function. Three studies suggest a beneficial effect in healthy volunteers and mild hypertensives. However potassium increases aldosterone due to a direct effect on the adrenal gland and there is evidence that aldosterone excess is detrimental to cardiovascular health. We therefore aimed to determine the effect of potassium supplementation on endothelial function in patients with...

ea0028p320 | Steroids | SFEBES2012

Use of the 250mcg short synacthen test to differentiate between patients with primary aldosteronism and essential hypertension

Graham Una , Hunter Stephen , McCance David , Atkinson Brew , Mullan Karen

Aberrant and upregulated eutopic receptors have been identified in vitro in patients with primary aldosteronism (PA). We previously identified an exaggerated aldosterone response to synacthen in patients with PA versus healthy controls. In this study we aimed to evaluate whether the synacthen test differentiates between patients with PA and essential hypertension (EH). The 250 mcg intramuscular synacthen test was performed after 30 minutes recumbency in the morning and off int...

ea0020p208 | Endocrine tumours and neoplasia | ECE2009

Laboratory diagnosis of gastrinoma remains difficult

Ardill Joy , Armstrong Lee , McCance David , Johnston Brian

Before the use of potent acid suppressing drugs and in particular proton pump inhibiters (PPI), most patients with gastrinoma presented with Zollinger–Ellison syndrome and diagnosis was problematic in only a few. In recent years, the syndrome is rarely seen and gastrinoma patients present with less overt symptoms and hypergastrinaemia which may be mild. Increasingly patients present later.In the population, hypergastrinaemia most commonly occurs bec...

ea0020p297 | Clinical case reports and clinical reports | ECE2009

Sustained response to interferon α in a patient with an advanced metastatic serotonin secreting endocrine tumour – case report

Ardill Joy , Johnston Brian , McCance David , Eatock Martin

This 52-year-old lady presented in 2001 at a GI clinic complaining of occasional abdominal cramps, which could be severe and prolonged. Her symptoms were not associated with diarrhoea or constipation. Weight loss of 4.5 kg over 4 months was noted. Coeliac disease was excluded and a diagnosis of severe irritable bowel was made.In January 2002 she returned to the clinic with further weight loss (total 8 kg), cyclical symptoms of diarrhoea lasting 3–5 ...

ea0068p33 | Abstracts | UKINETS2019

Confusion in a patient with Carcinoid syndrome

D'Arcy Robert , McCance David , Johnston Brian , Eatock Martin , Wallace Ian , Graham Una

We present a 66 year old man with a metastatic small bowel neuroendocrine tumour managed with resection of primary in 2011 and subsequent somatostatin analogue therapy. In 2018 disease progressed requiring right ureteric stenting due to extrinsic nodal compression. Three weeks later he presented with sweats, pyrexia and elevated inflammatory markers. Multiple blood and urinary cultures were clear. CT imaging, MRI spine and echocardiogram did not identify a source of sepsis. Ur...

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; ...