Endocrine Abstracts

Immunotherapies such as IL-2 and interferon have long been used in the treatment of certain cancers and immune mediated conditions. It has also long been recognised that their use is associated with an increased risk of autoimmune thyroid disease. Recent advances in the use of checkpoint inhibitors, such as ipilimumab and PD-1 inhibitors, in the treatment of a number of common cancers, as well as treatments such as alemtuzumab in multiple sclerosis have dramatically increased ...

Immunotherapies such as IL-2 and interferon have long been used in the treatment of certain cancers and immune mediated conditions. It has also long been recognised that their use is associated with an increased risk of autoimmune thyroid disease. Recent advances in the use of checkpoint inhibitors, such as ipilimumab and PD-1 inhibitors, in the treatment of a number of common cancers, as well as treatments such as alemtuzumab in multiple sclerosis have dramatically increased ...

Checkpoint Inhibitors have emerges as a major breakthrough in cancer therapy. Side effects are largely immune mediated, termed immune related adverse events. Whilst the majority of these respond to immunosuppressive treatment, most frequently glucocorticoids, endocrinopathies are amongst the more frequent adverse events, and usually lead to permanent hormone deficiency, requiring life long hormone replacement. There are differences in the pattern of endocrinopathy between diff...

Introduction: Hypophysitis has been recognised as a frequent endocrine related side effect of immunotherapy with the CLTA-4 inhibitor Ipilimumab, with a prevalence of upto 17.4%. The most common symptoms of hypophysitis are headache and signs/symptoms of hypopituitarism. Whilst some patients have an enlarged pituitary on MRI, this is frequently normal. ACTH and TSH deficiencies are most common, but all anterior and posterior pituitary hormonal axis may be affected. Hypopituita...

Case history: We have previously presented the case of a 31 year lady presenting with a seizure following exercise with a blood sugar of 1.4 mmol/l on a background of an 8 month history of episodic slurred speech, blurred vision and hunger relieved by eating in 2011.Investigations: Investigations confirmed an insulinoma and imaging, including Ga68 DOTATATE PET CT identified a lesion in the tail of the pancreas with multiple liver metastases. M...

A 58-year-old gentleman who was otherwise well presented with urinary symptoms. As part of his investigation for this he underwent a CT scan which showed an incidental 6 cm right adrenal mass compressing the inferior vena cava and superior pole of the right kidney with a 6-mm pulmonary nodule. He was subsequently found to have a raised urinary normetanephrine of 48.81 (normal range 0–3.3) suggestive that the mass was a pheochromocytoma. Retrospectively he reported episode...

Background: Paragangliomas are rare neuroendocrine tumours arising in the autonomic nervous system, which can secrete excess catecholamines, causing cardiovascular complications. Malignancy occurs in up to 23% of paragangliomas, resulting in a poor prognosis with a 5-year mortality of 43–63%. There’s a limited evidence base for their treatment, with no official guidelines. Peptide Receptor Radionuclide Therapy (PRRT) is a proven treatment for neuroendocrine tumours o...

Case history: A patient with malignant melanoma with multiple cerebral metastases and a left adrenal metastasis was treated with CRT (30Gy, 10 fractions). This was followed by 12 cycles of Nivolumab, after which the left adrenal lesion was managed with cyberknife (30Gy, three fractions) and Nivolumab was continued thereafter. The patient developed worsening deafness, became unsteady on his feet and complained of feeling generally unwell. At this time an MRI brain was performed...

Background: Immune checkpoint inhibitors have demonstrated significant advances in the treatment of several cancers including metastatic melanoma. However, they are frequently associated with immune-related adverse events which often require treatment with prolonged courses of glucocorticoids. Long-term glucocorticoid use is associated with several side effects including hyperglycaemia.Aims: 1) To determine the prevalence of glucocorticoid use in patien...

Somatostatinomas are rare neuroendocrine tumors usually arising from the pancreas and duodenum. Symptoms include hyperglycemia, cholelithiasis, diarrhea and steatorrhoea. Treatment with somatostatin (SST) analogue may appear paradoxical, but can lower SST levels and improve symptoms.Case: A 60-year-old gentleman presented with diarrhoea, opening his bowels between 12 and 13 times a day causing him to stop working and become depressed. Repeated fasting gu...