Endocrine Abstracts

Hypercalcaemia due to primary hyperparathyroidism during pregnancy may be associated with maternal and foetal complications as well as neonatal tetany. Asymptomatic women with mild hypercalcaemia may be managed conservatively. Symptomatic patients or those with severe hypercalcaemia should be offered parathyroidectomy in the second trimester. This session will summarise the current practice in the management of patients with hypercalcaemia during pregnancy at Hammersmith Hospi...

Hypercalcaemia due to primary hyperparathyroidism during pregnancy may be associated with maternal and foetal complications as well as neonatal tetany. Asymptomatic women with mild hypercalcaemia may be managed conservatively. Symptomatic patients or those with severe hypercalcaemia should be offered parathyroidectomy in the second trimester. This session will summarise the current practice in the management of patients with hypercalcaemia during pregnancy at Hammersmith Hospi...

All patients with phaeochromocytoma should undergo surgical resection by an experienced surgeon. Surgery should only be carried out after adequate medical preparation to minimize catecholamine-related adverse events. Pre-operative pharmacologic treatment is aimed at controlling hypertension and tachycardia, and volume expansion. This session will summarise the current practice in the medical management of patients with phaeochromocytoma at Hammersmith Hospital....

Case history: An 11 year old girl was diagnosed with von Hippel-Lindau disease (VHL) on cascade genetic screening due to a positive family history and was enrolled in a VHL surveillance programme. She developed bilateral phaeochromocytomas and underwent staged bilateral adrenalectomies at the age of 12 and 14. At the age of 16, she was discovered to have a 2.5 cm tail of pancreas pancreatic neuroendocrine tumour (pNET) on routine surveillance imaging. This enlarged during foll...

Case history: A 54 year-old gentleman was transferred as an inpatient from another centre for investigation and management of refractory hypoglycaemia following a revision gastric bypass. He was requiring a continuous infusion of 20% dextrose on transfer to maintain normoglycaemia. He had a complex bariatric surgical history dating back 7 years. His initial procedure had been a sleeve gastrectomy that was subsequently converted to a gastric bypass which had then been reversed ...

Background: In the UK, Growth Hormone (GH) is indicated for treatment of children with short stature secondary to growth hormone deficiency (GHD), Prader Willi syndrome (PWS), Turner syndrome (TS), SHOX gene mutation, chronic renal insufficiency and born small for gestational age (SGA).Objectives: The aim was to assess the compliance of our local practice with the NICE guidance for GH therapy in children in addition to local guidance that TFTs and IGF-I ...

Type 1 diabetes is a significant condition affecting school aged children with an increasing incidence in the UK. The effects of a chronic condition such as diabetes on a child can be dramatic and are particularly evident within the school setting. The impact of this condition can also be seen on parents, affecting their career, income and quality of life. Hence, this audit aims to identify the difficulties encountered by children in mainstream education, the impact of school ...

Patients with acromegaly have characteristic clinical features of soft tissue overgrowth. Both somatic and metabolic features of acromegaly are secondary to excess GH secretion and high circulating levels of insulin-like growth factor 1 (IGF1). However, an acromegaloid phenotype associated with severe insulin resistance is occasionally seen in the absence of biochemical hallmarks of acromegaly (insulin-mediated pseudoacromegaly). Here we present a case of ‘insulin-mediate...

Case history: A 26 year-old lady was admitted from clinic with severe hypertension and bilateral papilloedema. Six weeks prior to admission she had undergone resection of a massive right upper quadrant lesion that was felt to be of hepatic origin. Histological analysis of the lesion revealed it to be an adrenal phaeochromocytoma and she was thus referred to the endocrine service. Pre-operative biochemical assessment had not been performed but there was no evidence of any blood...

Case history: A 17 year old previously healthy male presented to his local emergency department with a generalised tonic seizure associated with severe hypertension (systolic blood pressure 240 mmHg) and tachycardia. He was intubated and admitted to the Intensive Care Unit. Antimicrobials to cover meningoencephalitis were commenced and his hypertension was managed with intravenous labetalol. He was extubated the following day. He had experienced headaches on a monthly basis fo...