Endocrine Abstracts

Hyperinsulinaemic-hypoglycaemia has been described following Roux-en-Y gastric bypass for obesity and is thought to be due to hyperfunction of pancreatic β cells. It has been questioned whether the β cell hyperfunction may have preceded the bariatric surgery and contributed to the obesity. We report a case of hyperinsulinaemic-hypoglycaemia in a non-diabetic, lean patient (BMI 26 kg/m2) who underwent distal gastrectomy and Roux-en-Y bypass for a benign gas...

A 73-year-old man was referred to the general medical clinic with a 3-year history of shortness of breath and wheeze. During assessment he commented that over the same period he had also had intermittent sweats, flushing and redness of the face especially after eating and taking red wine. Echocardiogram and urinary 24-h 5-hydroxyindoleacetic acid (5-HIAA) were arranged. Surprisingly two of three urinary 24-h urinary 5-HIAA were positive (43 and 47.5 μmol/24 h and 30 &#956...

The short synacthen test (SST) is the first-line test of adrenal insufficiency. Different centres have varying protocols for cortisol response. At Derriford Hospital cortisol is measured at 0, 30 and 60 min post-synacthen 250 μg (i.m./i.v.). A normal response is judged with a measured cortisol >550 nmol/l.A recent national audit questioned the bias created by the discrepancy between true cortisol (measured by mass spectrometry) and many laborato...

A 70-year-old woman was referred to the endocrine clinic with recently diagnosed diabetes mellitus and poorly controlled systemic hypertension. At presentation she had clinical features of Cushing’s syndrome including central obesity, Cushingoid facies and marked proximal myopathy. BP was 220/190. Initial biochemistry revealed plasma sodium 140 mmol/l, potassium 3.6 mmol/l and creatinine 82 mmol/l. Overnight 1 mg dexamethasone suppression test revealed cortisol 1148 mmol/...

A 48-year-old woman presented to her GP with polyuria and proximal muscle weakness. She was found to have newly developed hypertension at 180/96 and her serum potassium was 2.7 mmol/l. Lisinopril 40 mg od and Slow-K 1 tablet bd were started and she was referred for further investigation.On clinic review blood pressure was 188/110 supine and 190/110 standing. Serum sodium was 147 mmol/l, potassium 3.7 mmol/l and total bicarbonate 29 mmol/l. Her Lisinopril...