Endocrine Abstracts

Background: Insulin autoimmune syndrome (IAS) is characterised by spontaneous hypoglycaemia in the absence of exogenous insulin administration and high serum levels of immunoreactive insulin along with high titres of insulin antibodies. Although it is the third leading cause of hypoglycaemia in Japan, it is very rare in the western world. We present the first reported case of IAS in UK.Case report: A 27-year-old lady from south east-Asian background pres...

Introduction: Hyperparathyroidism in pregnancy is rare and is associated with significant maternal and fetal morbidity and mortality. Recognition can be challenging due to the inability to differentiate hypercalcaemia symptoms from those of pregnancy, studies suggest that up to 80% of cases may be undiagnosed. We report three cases of hyperparathyroidism in pregnancy at Royal Derby Hospital, investigations (Table 1) and management in these patients are reviewed.<p class="a...

Background: Insulin, derived from a single chain precursor pro-insulin, is cleaved by convertases to form insulin (t1/2 – 4 min) and C-peptide (t1/2 – 30 min). The ratio of insulin to C-peptide levels, which is usually less than one, is reversed in presence of exogenous insulin and insulin autoimmune syndrome. We present the significance of insulin-C-peptide ratio (ICR) in the diagnostic algorithm for the investigation of endogenous hyperinsulinaemia.<p class="ab...

Introduction: Incidental indeterminate adrenal nodules discovered on imaging in patients under the care of University Hospitals of Derby and Burton Foundation Trust are discussed in Urology MDT. MDT cases were reviewed for a 12 month period before an endocrinologist joined the MDT in January 2018 and 12 months afterwards, to review the compliance of local practice with European Society of Endocrinology (ESE) Guidelines for the management of adrenal incidentalomas.<p class=...

Aims and objective: Pegylated interferon is widely used in the treatment of hepatitis C. Thyroid dysfunction (TD) is a well recognised side effect of interferon treatment. As the use of interferon therapy in hepatitis C is on the rise, we conducted an audit to determine its prevalence and to formulate local guidelines for the monitoring and management of thyroid dysfunction in these patients.Methods: A case note based retrospective audit of all patients ...

The use of the simplified IM glucagon stimulation test (IMGST) over its standard counterpart in the diagnosis of GH and cortisol deficiency has been advocated. Despite apparent comparable diagnostic utility, the simplified IMGST is capable of producing false positive results, raising the potential for misdiagnosis if relied upon exclusively.The aim of this study was to re-evaluate the diagnostic utility of the two forms of the IMGST, ascertaining the mag...