Endocrine Abstracts

A 74-year-old man was referred urgently for investigation of recurrent phaeochromocytoma.In 2006, he was referred to another hospital with nocturnal sweating and tremors. He was found to have a left sided phaeochromocytoma which was removed laparoscopically with uneventful follow up. Unfortunately no initial results or histology were available on referral to our department.Follow up in primary care had involved annual 24 h urinary ...

A 34-year-old lady attended clinic-requesting information on recombinant prolactin to assist with breast feeding as she was 32 weeks gestation with her third pregnancy having failed to lactate after her first two pregnancies.In 2003 she developed pre-eclampsia during her first pregnancy and required delivery by Ventouse extraction. She had a significant post-partum haemorrhage of 1200 mls with haemoglobin 7g/dl but no evidence of cardiovascular compromis...

Background: We previously reported that a high number of synacthen tests are carried inaccurately within our trust with a significant delay in sample collection after tetracosactide injection. We also reported a high number of patients having Synacthen tests unnecessarily. In light of this we introduced a Synacthen proforma and re-audited our results.Method: A retrospective study was carried out on 36 patients undergoing Synacthen tests bet...

Background: We previously reported that a high number of synacthen tests are carried inaccurately within our trust with a significant delay in sample collection after tetracosactide injection. We also reported a high number of patients having Synacthen tests unnecessarily. In light of this we introduced a Synacthen proforma and re-audited our results.Method: A retrospective study was carried out on 36 patients undergoing Synacthen tests bet...

Background: Short Synacthen tests (SSTs) are used to assess adrenal function by injecting tetracosactide and measuring blood cortisol after 30 and 60 min. Many SSTs at Royal Bournemouth Hospital (RBH) are undertaken externally to the Bournemouth Diabetes and Endocrine Centre (BDEC). There is an increasing cost-implication for undertaking SSTs exacerbated by recent problems with Synacthen supply. A 0900 h cortisol or random cortisol on acutely unwell patients can be sufficient ...

Background: Short Synacthen tests (SSTs) are used to assess adrenal function by injecting tetracosactide and measuring blood cortisol after 30 and 60 min. Accuracy of timing helps enable successful interpretation of results. A SST is an invasive test although it is normally well tolerated. There is an increasing cost-implication for undertaking SSTs exacerbated by recent problems with Synacthen supply.Method: We undertook a retrospective audit of 333 pat...

Case history: A 42 year old female presented with a history of collapse and seizure activity. Her blood glucose was noted to be 3.1 with the paramedics and subsequent hypoglycaemia was demonstrated on several occasions whilst in hospital. She described a family history of insulinoma in her mother. A 72 h fast was performed as an inpatient to look for insulinoma. The nadir serum glucose was 2.0 mmol/l with an inappropriate C-peptide level of 1006 pmol/l and an insulin level of ...

A 21 year old Caucasian female with no known personal or family history of thyroid disease presented with several years history of anxiety and was found to have abnormal thyroid function tests. Results showed TSH: 1.8 mu/l (0.3–5.5), T4: 73 pmol/l (10–22), T3 12.3 pmol/l (3.1–6.8). Past medical history included chronic anxiety with no regular medications or nutritional supplements. There was no history of recent iodinated contrast administr...

Background: C-peptide is an amino-acid chain which is an equimolar marker of endogenous insulin. It is used to investigate the cause of non-diabetic hypoglycaemia and classification of diabetes. C-peptide can only be interpreted with a paired venous glucose <3 mmol/l for non-diabetic hypoglycaemia, and >4 mmol/l for diabetes classification.Aims and Objectives: To determine if: 1. C-peptide tests were requested for appropriate indication 2. Tests ...