Endocrine Abstracts

Background: Current guidance for the management of macroprolactinomas recommends full pituitary profile at baseline and subsequently only if symptomatic. Pituitary adenomas that co-secrete growth hormone and prolactin at presentation are well-recognised. Case reports of acromegaly after prolactinoma treatment are associated with symptomatic acromegaly. We present two patients with asymptomatic acromegaly years after diagnosis of macroprolactinoma.Patient...

Background: Graves’ disease (GD) is an autoimmune condition accounting for up to 80% of thyrotoxicosis cases.1 90% of these patients have TSH receptor antibodies (TRAbs).2 Current NICE guidance recommends testing for TRAbs in adults with confirmed thyrotoxicosis to differentiate between thyrotoxicosis with hyperthyroidism (e.g GD and toxic multinodular goitre) and thyrotoxicosis without hyperthyroidism (e.g thyroiditis).2Objective: To evaluate the n...

Primary hyperparathyroidism is rarely diagnosed in pregnancy; not only because it is uncommon in that age group but also because many of the symptoms overlap with non-specific pregnancy symptoms (nausea, vomiting, fatigue, constipation). Primary hyperparathyroidism with significant hypercalcaemia can potentially cause serious maternal (preeclampsia, nephrolithiasis, pancreatitis and hypercalcaemic crisis) and foetal (miscarriage, stillbirth, neonatal hypocalcaemia leading to t...

Introduction: Gestational transient thyrotoxicosis (GTT) affects 2–3% or pregnancies of European women and 11% of pregnancies of Asian women and typically resolves within the 2nd trimester. GTT rarely manifests with the typical symptoms of thyrotoxicosis and instead is associated with hyperemesis gravidarum. GTT can be confused with thyrotoxicosis occurring in pregnancy which requires prompt treatment with antithyroid drugs (ATDs) to minimise maternal and foetal risk. Inj...

Introduction: Primary hypothyroidism is most commonly caused by autoimmune hypothyroidism whilst additional causes include post radioactive iodine treatment (RAI) whereas central hypothyroidism is typically associated with pituitary disease. Treatment in primary hypothyroidism aims to maintain the TSH within the reference range whilst treatment of central hypothyroidism is aimed at maintaining free T4 in the upper half of the reference range as established by intern...

A 20-year-old lady presented to her GP with menstrual irregularity and worsening right-sided headaches with associated vomiting. Blood tests showed a mildly raised testosterone level and a markedly raised prolactin level, approximately 80% of which was macroprolactin (normal monomeric prolactin level). She was subsequently referred by her GP for an MRI Pituitary, which was reported as showing a 6-mm hypoenhancing lesion. Medical history includes migraines and hayfever; she was...

Introduction: Transsphenoidal pituitary surgery (TSPS) may be required either as a treatment for endocrinopathies or because of the risk or consequence of pituitary lesion expansion into adjacent structures, in particular optic chiasm compression. Published literature recommends surgery is performed by dedicated experienced surgeons with anticipated complication rates available as a comparator.Methods: This retrospective audit included all patients diagn...

Adrenal incidentalomas are a common clinical dilemma with increasing utilisation of cross-sectional imaging modalities. The aims of management include: i) exclusion of possible malignancy and ii) identification of hormonally active lesions.Our unit has adopted AACE guidelines, including a screen for adrenal androgen hypersecretion. This audit aimed to review the utility of such an approach.We identified case notes of 145 consecutiv...

Background: Thyroid disease in pregnancy is common with hypothyroidism predominating.Objectives: To determine the aetiology of thyroid disease in patients attending an antenatal thyroid clinic, their baseline biochemical and therapeutic characteristics as well as subsequent management.Subjects/setting: 114 women with a mean 31 years (±5) age were seen by a consultant endocrinologist in the antenatal thyroid clinic, between Sep...

Adrenal incidentaloma’s are a common clinical dilemma with increasing utilisation of cross-sectional imaging modalities. The aims of management include i) exclusion of possible malignancy and ii) identification of hormonally active lesions. Our unit has adopted AACE guidelines, including a screen for adrenal androgen hypersecretion. This audit aimed to review the utility of such an approach. We identified case notes of 100 consecutive adrenal incidentaloma’s referred...