Searchable abstracts of presentations at key conferences in endocrinology

ea0028p44 | Clinical practice/governance and case reports | SFEBES2012

Determining the utility of the 60 minute cortisol measurement in the short synacthen test

Chitale Aditi , Musonda Patrick , McGregor Alan , Dhatariya Ketan

Context: Despite the widespread use of the short synacthen test (SST), there remains no clear consensus on sampling times for the measurement of serum cortisol that best determines adrenal reserve.Objective: To establish whether there is any value in measuring serum cortisol at 60 minutes following administration of synacthen.Design and setting: Retrospective data analysis of 500 SST results measuring 0, 30 and 60 minute cortisol l...

ea0025p327 | Thyroid | SFEBES2011

Management of hyperfunctioning thyroid malignancy with psychiatric co-morbidity

Till David , Gilbert Jackie , Lewis Dylan , Crane James , Aylwin Simon , McGregor Alan

A 70-year-old female with known schizophrenia presented in hyperthyroid crisis. Examination revealed muscle wasting, tremor, sweating, low-grade fever, and sinus tachycardia. Biochemistry confirmed the diagnosis (TSH <0.1 mlU/l, thyroxine 41 pmol/l (9–25), tri-iodothyronine 25 pmol/l (3.5–6.5)). The patient was commenced on i.v. esmolol and carbimazole (40 mg) crushed into warm milk.However, lacking mental capacity, and refusing to take all...

ea0021p282 | Pituitary | SFEBES2009

Cortisol but not GH responses are dependent on symptoms during the glucagon stimulation test

Cheah Yee Seun , Lau Kristy , Gilbert Jackie , McGregor Alan , Aylwin Simon

The glucagon stimulation test is commonly used to assess the hypothalamic–pituitary axis when the insulin stress test (IST) is contraindicated. The mechanism behind glucagon induced secretion of GH and cortisol is unclear. To determine whether these responses are dependent on symptoms during the glucagon test, a retrospective case note study of glucagon tests performed over 3 years in patients with pituitary disease was undertaken.Methods: Fifty-six...

ea0021p407 | Thyroid | SFEBES2009

Should the cytological finding of Thy 3 mandate surgical excision?

Chakraborti Indrani , Aylwin Simon , McGregor Alan , Schulte Klaus Martin , Diaz-Cano Salvador , Gilbert Jackie

Introduction: Current guidelines recommend that thyroid nodules classified as Thy 3 following fine needle aspiration (FNA) should be managed surgically. This results in over-treatment of benign disease. The purpose of this study was to review multi-disciplinary team (MDT) management of Thy 3 FNAs at our institution.Patients and methods: A total of 109 FNAs were performed between April 2008 and October 2009; 31 were reported as Thy 3. The management of al...

ea0015oc20 | Tumours, diabetes, bone | SFEBES2008

Serum 18 hydroxycortisol identifies aldosteronoma in the differential diagnosis of primary aldosteronism

Narasimhan Sowmya , McGregor Alan , Miell John , Chambers Susan Mary , Abraha (Daines) Hagosa Demoz , Aylwin Simon

Introduction: 18-hydroxycortisol (18-OHF) is known to be elevated in glucocorticoid remediable aldosteronism but there are few data relating to 18-OHF in the differential diagnosis of primary aldosteronism.Aim: We evaluated the usefulness of lying and standing 18-OHF in patients with primary aldosteronism in differentiating between aldosteronoma, bilateral adrenal hyperplasia (BAH) and normality.Methods: Patients (n=27) with...

ea0013p106 | Clinical practice/governance and case reports | SFEBES2007

Adult growth hormone replacement using a fixed graded initiation phase followed by an individualised titration phase: a single centre experience

Lecka Agnieszka , Prague Julia , Oguntolu Victor , Miell John , McGregor Alan , Aylwin Simon

Most authorities recognise adult growth hormone deficiency (AGHD) as a distinct endocrine disorder, although determining an appropriate strategy for optimising replacement remains controversial.We reviewed the outcome of a cohort of patients treated with a fixed graded initiation phase followed by an individualised titration phase. Patients were initiated on a starting dose of 0.3 mg recombinant human growth hormone (rhGH) for one month, with increases t...

ea0031p22 | Bone | SFEBES2013

Renal replacement therapy to treat severe hypercalcaemic crisis: case series

Prague Julia , Mustafa Omar , Whitelaw Ben , Jenkins Rebeka , Crown Anna , Vaughan Nick , Schulte Klaus-Martin , Diaz-Cano Salvador , McGregor Alan

Background: The initial management of hypercalcaemia is well described: aggressive intravenous rehydration and subsequent intravenous bisphosphonates if required. Isolated case reports document the use of haemo/peritoneal dialysis and haemofiltration in the management of severe hypercalcaemia. We report three cases that required renal replacement therapy to treat severe hypercalcaemia.Case series: A 21-year-old male presented with abdominal pain and vomi...

ea0031p57 | Clinical practice/governance and case reports | SFEBES2013

Initiation and maintenance of mitotane as adjuvant therapy for adrenocortical cancer: a single centre experience

Whitelaw Benjamin , Mustafa Omar , Coskeran Patsy , Prague Julia , Kordbacheh Tiana , Lewis Dylan , Diaz-Cano Salvador , Sherwood Roy , Gilbert Jackie , McGregor Alan , Aylwin Simon

Background: Mitotane is an adrenolytic chemotherapy, currently accepted as first line adjuvant therapy in adrenocortical carcinoma. Mitotane has a narrow therapeutic window. Serum levels of >14 mg/l are required to achieve a cytotoxic effect and levels of >20 mg/l are potentially toxic. There are two strategies for mitotane initiation: a low-dose regimen (3 g) and a high-dose regimen (increase to 6g/day over 4 days and reduce to 4.5 g/day after 10 days).<p class="...

ea0031p158 | Neoplasia, cancer and late effects | SFEBES2013

Pituitary metasases: patients presenting with cranial nerve palsies and diabetes insipidus: a single centre experience

Salaris Paola , Kordbacheh Tiana , Whitelaw Ben , Mustafa Omar , Visca Anna , Thomas Nick , Bullock Peter , Barazi Sinan , Landau David , King Andrew , Hampton Timothy , Gilbert Jackie , McGregor Alan , Aylwin Simon

Background: Pituitary metastases are a rare complication of systemic malignancy. The most common presentations of pituitary masses include visual field defects, headaches, and hypopituitarism, but cranial nerve palsies and diabetes insipidus are also recognised although unusual. We aimed to determine if these were more frequently associated with pituitary metastasis.Methods: We conducted a review of 944 patients undergoing pituitary surgery from a teachi...

ea0031p257 | Pituitary | SFEBES2013

Endocrine remission of Cushing's disease after endoscopic trans-sphenoidal surgery: Retrospective review of a single centre experience

Kennard Devon , Whitelaw Ben , Dworakowska Dorota , Thomas Nick , Barazi Sinan , Bullock Peter , King Andrew , Hampton Tim , Sherwood Roy , Buchanan Charles , Gilbert Jackie , McGregor Alan , Aylwin Simon

Background: Cushing’s disease is caused by corticotroph tumours of the pituitary gland and the standard first-line treatment is trans-sphenoidal surgery. Published data from other centres describes post-operative endocrine remission achieved in 50–90% of cases.Table 1 Remission (cortisol <50)Cortisol (50–150 nmol/l)<td alig...