Endocrine Abstracts

Case history: A 39 year old lady was referred to the endocrinology clinic with difficulty conceiving, after screening bloods revealed an elevated prolactin (1816 miu/l)). There was no past medical history or family history of note and she took no regular medications. She denied headache, visual disturbance or galactorrhoea. Systemic examination was normal.Investigations: Elevated prolactin was confirmed on a cannulated sample (1435 miu/l). Further analys...

Case history: At 1 year follow-up post excision of invasive melanoma, a 63-year-old gentleman, with no other significant past medical history, was found to have CT evidence of metastatic disease. In the absence of a BRAF mutation, he was consented for combination immunotherapy with Ipilimumab (anti-CTLA4) and Nivolumab (anti-PD1). Monitoring bloods during cycle 2 of treatment revealed asymptomatic thyroiditis (TSH 0.03 miu/l, T4 35.5 pmol/l, T3 15.1 pmol/l), which did not requ...

Case history: A 73-year-old female with a background of hypertension presented to the acute physicians with a 4 month history of progressive headaches. The headaches did not have any ‘red flag’ features. A non-contrast CT scan revealed an intrasellar lesion. She was referred to endocrinology for further management. Her history did not suggest hypopituitarism, Cushing syndrome or acromegaly. There were no visual field defects and her eye movements were normal.<p c...

Background: Immune checkpoint inhibitors (ICIs), approved in the UK for the treatment of increasingly numerous malignancies, are commonly associated with endocrine sequelae, some of which may be life threatening. Society for Endocrinology guidelines detail management protocols for acute endocrinopathies, however widely accepted standards for their routine detection are lacking. Hypophysitis, clinically and radiologically silent in many, is seen in up to 15% of patients on ICIs...

Case history: A 28-year-old female was investigated for hypocalcaemia. Her calcium level was checked because her mother was found to be hypocalcaemic post thyroidectomy for recurrence of Graves disease. Further detailed history taking revealed that the patient’s grandmother often complained of hand cramps on kneading dough. The patient’s aunt was believed to have a parathyroid disorder; no further details were available. On further investigation, it was apparent that...

Background: Diabetes insipidus (DI) is a recognised complication of pituitary surgery, with current diagnosis requiring clinical observation aided by plasma and urine electrolytes and osmolalities. Copeptin, a 39 amino acid glycopeptide secreted in equimolar quantities to ADH, is a stable surrogate marker of ADH release and has potential to facilitate prompt diagnosis of post-operative DI. This assay has been shown to accurately predict which patients are likely to develop DI ...