Searchable abstracts of presentations at key conferences in endocrinology

ea0055we12 | Workshop E: Disorders of the adrenal gland | SFEEU2018

The octagenarian with a phaeochromocytoma: a new management dilemma

Glyn Tessa , Thomas Julia

Increased use of abdominal imaging has resulted in vast numbers of adrenal incidentalomas being identified (Bovio et al., 2006). Guidelines exist for identifying hormone excess and diagnosing malignancy but there is little evidence about how to manage phaeochromocytoma in patients who are poor surgical candidates. We present the case of a frail 88 year-old lady who was found to have a right adrenal incidentaloma during assessment for abdominal pain. Mrs R is able to m...

ea0038p346 | Pituitary | SFEBES2015

Silent corticotroph adenoma presenting with severe visual loss

Rich Laura , Thomas Julia , Grieve Joan

A 51-year-old man presented to an optometrist with a 3-week history of visual impairment following a minor headache. He was found to have reduced visual acuity 6/24 in both eyes and a dense bitemporal hemianopia and was referred urgently to Musgrove Park Emergency Department. MRI brain showed a cystic bleed from a pituitary macroadenoma, 30 mm in diameter, with compression of the optic chiasm. He had no clinical features of Cushing’s or other hormone excess or deficiency ...

ea0025p164 | Diabetes, metabolism and cardiovascular | SFEBES2011

Chronic GH excess is associated with adenosine monophosphate-activated protein kinase (AMPK) threonine-172 phosphorylation changes that do not lead to changes in AMPK activity

Thomas Julia , List Edward , Kopchick John , Grossman Ashley , Korbonits Marta

GH influences multiple metabolic pathways. Excess GH (acromegaly) causes a distinct form of cardiomyopathy, which may progress to fulminant heart failure. AMPK is an energy conservation enzyme that modulates multiple areas of the cell stress response, inhibiting anabolism and promoting catabolism. AMPK is activated by phosphorylation at Thr172 and measurement of Thr172 phosphorylation is thought to correlate with enzyme activity. We investigated the influence of GH on cardiac ...

ea0015p238 | Pituitary | SFEBES2008

Successful use of once weekly pegvisomant administration in patients with acromegaly

Higham Claire , Thomas Julia , Drake Will M , Trainer Peter

Initial clinical trials with pegvisomant at doses of up to 80 mg once weekly led to a 30% fall in IGF-I. Subsequently, daily administration of up to 40 mg/day (280 mg/week) achieved an IGF-I within reference range in 97% of patients. Pegvisomant’s half-life is >70 h suggesting weekly dosing may be possible using higher doses than in the original trials.We performed a two-centre, open-label prospective study in seven patients (4M, 3F, mean age 57...

ea0059p160 | Obesity & metabolism | SFEBES2018

Screening for Cushing’s syndrome in a tier 3 weight management service

Glyn Tessa , Ho May , Lambert Anthony Paul , Thomas Julia , King Rhodri , Douek Isabelle , Andrews Robert

There is limited evidence for the role of screening for Cushing’s syndrome (CS). Patients referred to the specialist medical weight management service at Musgrove Park Hospital have routinely been screened for CS with either an overnight dexamethasone suppression test (ODST) or two 24hour urinary free cortisol (UFC) if evidence of dysglycaemia. We retrospectively analysed the results of all patients referred to the service between 2013–2016. 794 patients were seen as...

ea0015p74 | Clinical practice/governance and case reports | SFEBES2008

An adrenaline-secreting phaeochromocytoma in pregnancy

Thomas Julia , Vearncombe Laura , Perry Les , Sanghi Anita , Carpenter Robert , Akker Scott

A 37-year-old woman, 30 weeks pregnant, presented with palpitations and abdominal cramps. Ultrasound demonstrated a supra-renal abnormality and MRI showed a 10 cm heterogeneous left adrenal mass. For five years she had experienced episodes of palpitations, shaking, sweating and chest tightness. She was investigated by a neurologist and diagnosed with temporal lobe epilepsy. During pregnancy the frequency of episodes increased. Lamotrigine was started, but at each dose increase...

ea0015p373 | Thyroid | SFEBES2008

An unusual cause of a thyroid mass

Thomas Julia , Norton Andrew , Calaminici Maria , Plowman P Nicholas , Richards Polly , Alusi Ghassan , Montoto Silvia , Akker Scott

A 24-year-old woman presented with stridor resulting from a large, firm, anterior neck mass. At age six she had been treated for acute lymphoblastic leukaemia (ALL) with vincristine, prednisolone, daunorubicin, asparaginase, prophylactic cranial radiotherapy and intrathecal methotrexate. She also had primary hypothyroidism with strongly positive thyroid peroxidase antibodies.The mass had been gradually enlarging for 6 months, causing exertional breathles...

ea0034p232 | Obesity, diabetes, metabolism and cardiovascular | SFEBES2014

High incidence of cardiac involvement in patients diagnosed with phaeochromocytoma: a clinical study using cardiovascular magnetic resonance imaging

Ferreira Vanessa , Rodrigues Mafalda , Piechnik Stefan , Marini Claudia , Karamitsos Theodoros , Francis Jane , Arnold Ranjit , Mihai Radu , Thomas Julia , Herincs Maria , Korbonits Marta , Hassan-Smith Zaki , Arlt Wiebke , Karavitaki Niki , Grossman Ashley , Neubauer Stefan , Wass John

Background: In patients with phaeochromocytoma, sudden and/or chronic exposure to catecholamines may predispose to cardiac pathology, including left ventricular (LV) hypertrophy, myocardial infarction, stress-induced cardiomyopathy and heart failure. We conducted the first prospective, multicentre study using cardiovascular magnetic resonance (CMR) imaging to describe the variety and incidence of cardiac abnormalities in phaeochromocytoma.Methods: Fifty ...

ea0028p251 | Pituitary | SFEBES2012

The characterisation of growth hormone-related cardiac disease with magnetic resonance imaging

Thomas Julia , Dattani Abhishek , Burchell Thomas , Zemrak Filip , Khoo Bernard , Chew Shern , Kaplan Felicity , Drake William , Aylwin Simon , Gurnell Mark , Akker Scott , Petersen Steffen , Davies Ceri , Grossman Ashley , Korbonits Marta

Acromegaly causes a distinct cardiomyopathy. Growth hormone deficiency (GHD) limits cardiac response to exercise and increases cardiac mortality. Cardiac magnetic resonance imaging (CMR) is considered the gold standard for assessment of cardiac mass and provides data on function, fibrosis, valves and ischaemia. Twenty-three patients with abnormal GH levels (acromegaly, n=13; adult-onset GHD, n=10) and 23 matched controls underwent CMR. Patients had repeat CMR at ...