Endocrine Abstracts

In clinical settings, when biochemical screening revealed grossly elevated urinary normetanephrine and metanephrine in the presence of an adrenal mass, there is a high clinical suspicion of a pheochromocytoma. However, sulfasalazine, an anti-inflammatory drug can cause analytical drug interference, leading to falsely positive elevation of urinary normetanephrine and a misdiagnosis of phantom pheochromocytoma. This report illustrates two patients with adrenal mass who had false...

An 80 year old patient was diagnosed with asymptomatic, mild primary hyperparathyroidism in 2005 and managed conservatively with regular biochemical monitoring. Other medical history included atrial fibrillation, hypertension, CKD stage 3, type 2 diabetes and memory impairment. In 2011, in view of increasing calcium, he was referred to the endocrine surgeons to consider parathyroidectomy. A very low 25 (OH)vit D (12 nmol/L) prompted high dose oral cholecalciferol treatment. Th...

Introduction: There is variation in practice with regards to preoperative optimization protocols and postoperative management in pheocromocytoma and related paraganglioma (PPGL). We aimed to review the literature on perioperative strategies to reduce morbidity and mortality following surgery for PPGL and enhance understanding of optimal approaches.Methods: Two databases were systematically searched in January 2020 for terms related to perioperative manag...

A 60-year-old woman was referred with a 14 mm right adrenal mass on a contrast CT abdomen whilst being investigated for left iliac fossa pain and increased bowel frequency. She reported a 2-year history of anxiety attacks, poor sleep, excessive sweating and weight loss. She had hypertension, asthma and recurrent vasovagal syncope and had previously undergone an open cholecystectomy. Her medications included Lansoprazole, Salbutamol, Losartan, Citalopram and Diltiazem. Systemic...

Background: Traditional method in Sheffield involved preoperative admission and use of an intensive regimen. The pandemic led to the development and implementation of an outpatient-based protocol (SPROG - ‘Sheffield Peri-operative Rapid Optimisation in Graves’ disease (GD)’) for patients’ intolerant to thionamides and/or with uncontrolled disease requiring thyroidectomy. Control was achieved using sequential addition and dose-escalation of drugs such as Lug...

Background: Papillary thyroid cancer is the commonest thyroid malignancy. Surgery is first-line treatment, followed by radioiodine and long-term, high dose levothyroxine to suppress TSH.Cortisol is known to suppress TSH secretion by the pituitary, although the mechanism remains unclear. Correspondingly, hypocortisolism may raise TSH levels.Case Summary: A 64 year old woman presented with a right-sided thyroid nodule, normal TSH and...