Endocrine Abstracts

A 33-year-old woman who was 38-weeks pregnant was referred to our Endocrine team for bilateral temporal hemianopia. Her past medical history includes juvenile myoclonic epilepsy, for which she takes lamotrigine 275mg BD. She was reviewed by the Endocrinologist in 2018 for polyuria and nocturia which were attributed to the introduction of antiepileptics (normal pituitary biochemistry and MR pituitary). Her symptoms subsequently improved. Current symptoms started with acute retr...

Case History: A 61 year old woman on haemodialysis with end stage renal failure secondary to immune-complex mediated diffuse proliferative glomerulonephritis was admitted with accelerated hypertension presenting with acute right microvascular 6th nerve palsy and left optic nerve ischaemic atrophy. Her BP had been well controlled over the last 10 years but since the end of 2020 systolic BP readings were frequently recorded above 200mmHg. Multiple antihypertensive classes were c...

Case history: A previously asymptomatic 58-year-old gentleman presented following an out-of-hospital cardiac arrest, precipitated by multiple, bilateral pulmonary emboli.Investigations: In the course of investigation, a 35 mm, MIBG-negative, right adrenal lesion was discovered. Functional adrenal tests revealed significantly elevated normetanephrine and 3-methoxytyramine levels. Severe hypertension and type 2 diabetes were concurrently diagnosed.<p c...

Case history: An 18-year old lady being investigated for anaemia, was incidentally found to have a 15 cm left adrenal mass. History taking revealed a 6-month history of weight gain, fatigue, and hirsutism. Past medical history was positive for mental illness. There was no learning disability or history of epilepsy. Physical examination was unremarkable.Investigations: Biochemical work-up for a functional adenoma revealed normal serum cortisol and circadi...

Introduction: Increased cardiovascular risk in hypopituitary patients was first documented by Rosen in 1990. Subsequent studies confirmed increased prevalence of cardiovascular and cerebrovascular disease in these patients. The exact mechanism for this is unclear. There is no clear consensus on how best to quantify or predict cardiac risk in hypopituitarism. QRISK2 cardiovascular disease risk algorithm provides estimates of 10-year cardiovascular disease (CVD) risk in patients...

Introduction: Patients with craniopharyngioma are characterised by a high incidence of hypopituitarism, visual failure and hypothalamic dysfunction. Standardised mortality is markedly elevated and controversy exists about optimal treatment.Aim: We aimed to examine the temporal trends in the treatment of craniopharyngioma at our centre. Also, we sought to examine treatment needs and long-term morbidity in this patient group.Methods:...

Background: The glands most commonly affected in MEN1 are parathyroid, pituitary and pancreas. Pancreatic neuroendocrine tumours (pNETs) are of foregut origin, but a number of other so-called ’foregut carcinoid tumours’ may also occur in MEN1, including tumours of bronchial, thymic, and gastrointestinal origin. Reported rates of prevalence of these latter tumours vary from 2% for thymic and bronchial carcinoids, to 10% for gastric carcinoids. Thymic carcinoids have b...

Introduction: Regimens for pre-operative α and β-blockade for patients with secretory phaeochromocytomas/paragangliomas vary widely between centres. The worldwide lack of availability of intravenous phenoxybenzamine (Goldshield) has removed a useful tool in the management of phaeochromocytoma crisis and has necessitated a change in our institution’s routine pre-operative strategy. We compare pre, peri and post-operative surrogate measures of blockade in a cohort...

Thalassaemia patients are transfusion dependent and at risk of iron overload with end organ damage. Iron deposition is reduced by chelation treatment. We present the data on endocrinopathy and bone density in the adult patients under our care with thalassaemia. In addition, we will discuss therapeutic approaches to these problems including the use of newer chelation agents and possible reversal of endocrine end organ damage. We will also review the correlation in our patients ...

Background: Primary aldosteronism (PA) is a common, curable and high-risk subset of hypertension, mandating detection. In all but the most severe cases, learned society guidelines recommend confirmatory testing. Whilst a variety of confirmatory tests exist, data describing their safety are limited. Concerns centre around the potential of some tests to precipitate hypokalaemia or a hypertensive emergency in a patient with PA on sub-optimal anti-hypertensive medication. In this ...