Endocrine Abstracts

Background: Normal maternal thyroid function is essential for optimal fetal neurological development. However, targeted screening for thyroid dysfunction in the first trimester of pregnancy, together with the criteria that should be applied, remains controversial.Aim: To determine the efficacy of targeted screening for discovering new cases of thyroid dysfunction in pregnancy.Method: All women who delivered their babies at Imperial...

Case history: A 40-year-old, primaparous woman was referred at 24 weeks’ gestation to Obstetric Medicine for review of abnormal thyroid function tests (TFTs).Investigations: One year prior to pregnancy, TFTs included a thyroid stimulating hormone (TSH) level of 0.95 mU/l (local non-pregnant reference range 0.3–4.2 mU/l) and a free thyroxine level (fT4) of 7.3 mU/l (local non-pregnant reference range 9.0–23.0 mU/l). At 18 weeks’ gestat...

A 58 year old female, with a 15 year history of hypertension and recent poor control, was admitted to the emergency department after an out of hospital cardiac arrest due to ventricular fibrillation requiring DC cardioversion. Initial investigations showed a metabolic alkalosis with profound hypokalaemia at 1.7 mmol/l. In view of lateral ST depression on the ECG post-resuscitation, she underwent an urgent coronary angiogram which demonstrated unobstructed coronary arteries. Wh...

Background: GLP-1/glucagon dual agonists are being developed as treatments for obesity due to their combined effect of reducing food intake while increase energy expenditure. Though the effect of the dual agonist on carbohydrate and lipid metabolism is well studied, little is known about the effects on protein metabolism. This study aimed to examine the acute and chronic effects of the GLP-1/glucagon dual agonist on amino acid metabolism.Methods: The lon...

Non-islet cell tumour hypoglycaemia (NICTH) is a rare paraneoplastic phenomenon and there is limited guidance regarding different treatment modalities.We present two cases of NICTH focusing on the combined methods used to control hypoglycaemia.The first involves an 89-year-old gentleman diagnosed with a pelvic leiomyoma in 2003. For several years, he had experienced recurrent collapses which briefly improved following tumour emboli...

Objective: Our objective was to examine recurrence of hyperprolactinaemia following discontinuation of dopamine agonist (DA) therapy in patients with macroprolactinoma who have had treatment for 3–15 years.Methods: We identified retrospectively adult patients (n=15) attending OCDEM (Churchill Hospital, Oxford, UK) with a confirmed diagnosis of macroprolactinoma (established during the last 25 years), who had been treated with DA therapy for a...

De novo vasopressin insufficiency (VI) is extremely rare in patients with pituitary adenoma who have not had biopsy or surgery and raises the question of differential diagnoses including malignancy and infective or inflammatory disease affecting the pituitary. Here we present a case of a patient initially presenting with cystic pituitary adenoma subsequently developing VI. A 24 year old woman presented to her GP with headache and secondary amenorrhoea. MRI brain revealed a cys...

Section 1: Case history: A 68 year old lady presented with a 2 week history of pedal swelling, with large blisters appearing on her feet. Her past medical history included adrenal Cushing”s treated with a right laparoscopic adrenalectomy on a 4.7x5.2 cm lipid poor adenoma 12 years previously; she had been discharged 7 years ago after repeated normal overnight dexamethasone suppression tests. Over the last year she had gained 12 kg in weight and been diagnosed with type 2 ...

Background: Dexamethasone significantly improved outcomes in patients requiring supplementary oxygen and in ventilated patients with COVID-19 in the RECOVERY trial. Consequently, dexamethasone is now routinely used in these patients. However, dysglycaemia is commonly associated with steroid use and is an established risk factor for poorer outcomes in COVID-19. In this study, we aimed to elucidate the effect of dexamethasone use in patients hospitalised with COVID-19 in a real-...

Introduction: Diabetes has been associated with poorer outcomes with COVID-19 infection, but precise predictors of mortality in patients with diabetes remain unclear. We assessed predictors of adverse outcomes in patients hospitalised with COVID-19 in Imperial College Healthcare NHS Trust (ICHNT) hospitals during the first and second waves of COVID-19 to determine if outcomes for patients with diabetes have evolved with new variants and treatments.Method...