Endocrine Abstracts

Background/aims/method: Evaluation/management of adrenal incidentalomas (AI) is an increasingly prevalent challenge. CT/MRI characteristics may be useful in determining whether a lesion is a benign adenoma and forthcoming ESE-ENSAT guidance suggests a role for 18F-FDG-PET/CT in distinguishing benign vs malignant lesions. We have previously demonstrated the utility of 11C-metomidate (MTO), which binds CYP11B1/B2, in localising aldosterone-producing adenoma...

Context: Primary aldosteronism (PA) accounts for 5–10% of all hypertension and 20–25% of refractory cases. Diagnosis is important as PA is associated with increased morbidity and mortality compared with ‘essential’ hypertension, and up to 50% of patients may benefit from unilateral adrenalectomy. Screening requires measurement of plasma renin activity (PRA) or concentration (PRC), and plasma aldosterone concentration (PAC), to yield an aldosterone:renin rat...

Context: Primary aldosteronism (PA) accounts for 5–10% of all hypertension and 20–25% of refractory cases. Diagnosis is important as PA is associated with increased morbidity and mortality compared with ‘essential’ hypertension, and up to 50% of patients may benefit from unilateral adrenalectomy. Screening requires measurement of plasma renin activity (PRA) or concentration (PRC), and plasma aldosterone concentration (PAC), to yield an aldosterone:renin rat...

Background and aims: We have previously reported an increased prevalence of gallbladder polyps in treatment-naive acromegaly when compared with the general population (29 vs 4.6%), with potential implications for future malignant transformation and screening. However, little is known about biochemical markers of liver function in active acromegaly, or in response to treatment. Furthermore, somatostatin analogue (SSA) therapy is associated with the development of gallstones. He...

Background: Accurate assessment of GH & IGF1 status in acromegaly is crucial for informing management to minimise excess morbidity/mortality. Expert panels have differed with respect to recommended testing modalities and thresholds – the most recent being the Endocrine Society 2014 guidelines. We evaluated their simplified algorithm, which minimises the need for day-case testing, against other more resource-intensive measures.Methods: A retrospe...

Case history: A 38-year-old man was referred with a 12-month history of recurrent bouts of transient hyponatraemia (serum sodium ranging from 115 to 125 mmol/l). Citalopram, which he was taking for depression, was discontinued, but the episodes continued.Initial investigations: Whilst symptomatic, and clinically euvolaemic, his biochemical profile was consistent with a syndrome of inappropriate antidiuresis (SIAD): sodium 124 mmol/l, potassium 4.5 mmol/l...

Background & Aims: The aims of transsphenoidal surgery (restoration/preservation of vision and amelioration of hormonal excess) are balanced against the risk of inducing new post-operative pituitary deficits. This study aims to assess the rate of new anterior hormonal deficits following transsphenoidal pituitary adenoma surgery in our centre and to assess whether the visibility of normal pituitary gland on pre-operative imaging predic...

Background & Aims: The aims of transsphenoidal surgery (restoration/preservation of vision and amelioration of hormonal excess) are balanced against the risk of inducing new post-operative pituitary deficits. This study aims to assess the rate of new anterior hormonal deficits following transsphenoidal pituitary adenoma surgery in our centre and to assess whether the visibility of normal pituitary gland on pre-operative imaging predic...

Case history: A 66-year-old man presented with a 1 month history of a productive cough, in the context of a 20 pack-year smoking history. CT chest revealed minor bronchiectasis and an incidental 3 cm right adrenal lesion. He was referred to the endocrine clinic for further evaluation. On questioning, he reported no symptoms suggestive of adrenal hormone hypersecretion and, aside from a short history (<1 month) of sweating episodes at night, he described no other constituti...

Background: Primary aldosteronism (PA) is now recognised to account for 5–10% of all cases of hypertension (and 20–25% of refractory hypertension). For patients with a demonstrable unilateral cause, adrenalectomy offers the potential for cure of PA, although resolution of hypertension occurs in only ~50% of patients. We have examined histological appearances and radiological features in patients with APAs undergoing adrenalectomy in an attempt to further our understa...