Endocrine Abstracts

Delay in establishing a diagnosis of adrenal insufficiency can lead to adrenal crisis. An adrenal crisis is a potential life-threatening complication of adrenal insufficiency, and can lead to increased morbidity and mortality if not treated appropriately. Adrenal crises have been defined as ‘acute disturbances of physiology that happen when the circulating levels of adrenal steroid hormones are insufficient for physiological requirements’. Adrenal crisis related deat...

Introduction: Acromegaly is caused by excessive growth hormone production and elevated IGF-1 levels. Annual incidence rates are reported to be between 0.2 and 1.1 cases/100 000 people, with a prevalence of 2.8–13.7 cases/100 000 people. Small numbers make it difficult to differentiate any differences between sex. A recent increase in the number of females diagnosed with acromegaly at our centre, voiced a need for peer and psychological support. It is known that acromegaly...

Aim: To determine the prevalence of vitamin D insufficiency in Asian patients with type 2 diabetes and to determine the most appropriate screening investigations.Introduction: The high prevalence of vitamin D deficiency and type 2 diabetes in the Asian community is well recognised. Vitamin D insufficiency (levels < 50 nmol/l) is associated with impaired insulin secretion and increased insulin resistance. The prevalence of Vitamin D insufficiency in p...

Background: The National Patient Safety Alert (2020) and introduction of the NHS Steroid Emergency Card has led to the development of guidelines, publications and patient information, aiming to improve safety and management of adrenal insufficiency and prevention of adrenal crisis. Health Education England (HEE), ‘Plain English’ and NHS England guidance recommends patient information is accessible and clear to a broad range of people, to ensure patients are fully awa...

Background: Insulinoma is the most common cause of hypoglycaemia due to endogenous hyperinsulinemia. However, they can sometimes present with atypical features. Some of the patients can also develop serious adverse effects to medical treatment. We present a case with atypical features and further developed serious adverse effects with medical treatment for insulinoma.Case presentation: A 42-year-old Caucasian female presented with recurr...

Introduction: In 2015, a service evaluation of endocrine clinical nurse specialist (CNS) nurse led clinics (NLC) demonstrated they took on a variety of formats to meet local service and patient population requirements. Continuing professional development (CPD) is a fundamental and legal requirement of nursing practice. However, because of the introduction of NMC revalidation in 2016 and recent medicolegal developments such as confidentiality, duty of can...

Introduction: In 2015, a service evaluation of endocrine clinical nurse specialist (CNS) nurse led clinics (NLC) demonstrated they took on a variety of formats to meet local service and patient population requirements. Continuing professional development (CPD) is a fundamental and legal requirement of nursing practice. However, because of the introduction of NMC revalidation in 2016 and recent medicolegal developments such as confidentiality, duty of can...

A 69-year-old South Asian male presented in A+E with hyponatremia. He had pervious history of Lyme Node TB (treated 2014), Asthma and Nasal Polyps. Medication history, patient was taking Fludrocortisone nasal spray for the 30–40 years and Seretide inhaler. Also, CT scans at admission did not identify relapse in Lyme Node TB. Upon investigation he was found to have undetectable morning cortisol (<28 mmols). He was started on Hydrocortisone 10 mg, 5 mg and 5 mg regime, ...

Background: Current practice of monitoring adrenal incidentalomas with biochemical follow-up and repeat imaging studies is under review by the ESE.Following an audit presented in 2015, we proposed that this extensive follow-up was unnecessary in radiologically benign lesions, as neither functional nor malignant lesions were present in this subgroup.Methods: A retrospective review of the same cohort of 145 patients with adrenal inci...

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...