Endocrine Abstracts

Case history: A 40-year-old woman presented with long-standing hypokalemia fluctuating between 2.3 and 2.5 mmol/l. She had episodes of right-sided weakness and was seen by Neurologists without a clear diagnosis. She had no other past medical history. Physical examination was unremarkable. Her blood pressure (BP) was 116/63.Investigations: Plasma aldosterone was 1363 pmol/l. Plasma renin activity was 0.18 ng/ml/h. Aldosterone-renin ratio (ARR) was 7570 (n...

Unilateral forms of primary aldosteronism (PA) should, by inference, have a contralaterally normal and therefore suppressed adrenal zona glomerulosa. However, there is no agreed definition of expected adrenal suppression. We hypothesized two biochemical definitions of adrenal suppression based upon measurements done during adrenal vein sampling. These were then applied to a PA–AVS-outcomes database to determine whether either definition proved useful for interpretation of...

Introduction: We present a case of primary aldosteronism (PA) with adrenal mass, where lateralization of aldosterone production by adrenal-vein sampling (AVS) was discordant with cross-sectional imaging. We highlight an approach to investigation of PA using functional nuclear imaging, and show that subclinical cortisol excess may impact the reliability of AVS.Case: 70 year old female with 2.6 cm left-sided adrenal mass, ...

Background & Aims: Neuroendocrine tumours (NET) are a heterogenous group of neoplasms that secrete peptides and neuroamines. For potentially malignant gastroenteropancreatic (GEP) NET, surgical resection represents the only curative option. Ten-year imaging surveillance programs using cross sectional imaging are recommended due to long time-to-recurrence following resection. We performed a retrospective chart review to evaluate radiation exposure associated with surveillan...

Introduction: Adrenal vein sampling (AVS) is considered gold-standard for diagnosis of unilateral primary aldosteronism (PA), and necessary pre-surgery. Imaging-AVS discordance may occur in up to 30-40% of PA-AVS series, and presents a diagnostic dilemma which may preclude surgery. Lateralization by AVS is defined as the ratio of aldosterone concentrations normalized by cortisol from each adrenal vein, and is thus sensitive to any pathologic asymmetry in corti...

Objective: The 2016 ATA RR assessment recommendations for patients with DTC were based on retrospective studies. We present the first outcomes of a prospective assessment of thyroid cancer management according to the ATA RR stratification.Methods: Using the Calgary prospective thyroid cancer database, we identified 612 patients with differentiated thyroid cancer (DTC) treated at our centre between April 2017 and December 2021. Each case was reviewed by t...

Background: Telotristat etiprate (TE), an oral tryptophan hydroxylase inhibitor, is intended to treat carcinoid syndrome (CS) by reducing serotonin production. TE was evaluated in TELESTAR, a phase 3 study; the primary endpoint showed significant reductions in bowel movement (BM) frequency for 2 TE dosages + standard of care (SOC) vs. SOC. TELESTAR patients had CS inadequately controlled on somatostatin analog therapy with ≥4 BMs per day. They were interviewed about base...