Endocrine Abstracts

SB, a 54-year-old male, was diagnosed with NF1 aged 11 on the basis of multiple café au lait spots and neurofibromas. In 1991 he presented with diarrhoea and weightloss and investigations revealed a duodenal mass and suspected hepatic metastases. Somatostatin levels were elevated, and histology confirmed a duodenal somatostatinma following Whipple’s procedure in 1991. The hepatic metastases were excised with good results. At follow up, SB remained symptom free treate...

Background: Prevalence of FHH in hypercalcaemic patients with a raised PTH has been quoted as 1 in 20. Parathyroidectomy has no benefit and therefore it is important to exclude FHH prior to considering surgery.Objectives: The aim of our study was to idenitify hypercalcaemic patients with a 24 hour urine calcium creatinine ratio (Ca/Cr) between 0.01–0.02 with a view to propose a cut-off ratio of 0.015 which will provide optimal...

Background: Prevalence of FHH in hypercalcaemic patients with a raised PTH has been quoted as 1 in 20. Parathyroidectomy has no benefit and therefore it is important to exclude FHH prior to considering surgery.Objectives: The aim of our study was to idenitify hypercalcaemic patients with a 24 hour urine calcium creatinine ratio (Ca/Cr) between 0.01–0.02 with a view to propose a cut-off ratio of 0.015 which will provide optimal...

Somatostatin analogues (SSA) have an established role in the medical management of patients with neuroendocrine tumours (NETs). They are effective in the symptomatic treatment of some metastatic NETs and may also provide tumour stabilisation or reduction. We report two patients with disease progression who benefited from SSA. Mrs HW, 64-year old woman, was diagnosed with a grade 1 small-bowel NET with lymph node and liver metastasis in 2012: Ki-67 index < 1%. Despite a seg...

Introduction: Current guidelines from The Endocrine Society indicate that 2 different tests from urinary free cortisol (UFC) measurement, salivary cortisol (SC) measurement, low-dose dexamethasone suppression test (LDDST) or overnight dexamethasone suppression test (ODST) are required to diagnose Cushing’s syndrome (CS). The low-dose dexamethasone test (LDDST) is often used as the confirmatory test when diagnosing CS. The overnight d...

Introduction: Current guidelines from The Endocrine Society indicate that 2 different tests from urinary free cortisol (UFC) measurement, salivary cortisol (SC) measurement, low-dose dexamethasone suppression test (LDDST) or overnight dexamethasone suppression test (ODST) are required to diagnose Cushing’s syndrome (CS). The low-dose dexamethasone test (LDDST) is often used as the confirmatory test when diagnosing CS. The overnight d...

Ectopic Cushing’s syndrome is a rare condition accounting for 10–20% of all cases of ACTH-dependent Cushing. Neuroendocrine tumours (NETs), mainly bronchial carcinoids and small cell lung cancer, are the most frequent causes of ectopic ACTH secretion(1). Here we report two challenging cases with long duration of surveillance and monitoring.Case 1: A 42-year-old lady with a florid Cushing syndrome underwent bilateral adrenalectomy in 2002. An IP...

We report a 55-year-old non-smoker with a history of Graves’ disease diagnosed in 1990 at age 29 years old. Due to poor compliance to therapy, she underwent a total thyroidectomy within 1 year of diagnosis. She remained well controlled on thyroid hormone replacement for over 20 years with Levothyroxine 100 μg daily. However, in the two years before referral to the Endocrine Clinic, she had difficult to treat hypothyroidism with persistent over-replacement; at the tim...

We report a 55 year old non-smoker with a history of Graves’ disease diagnosed in 1990 at age 29 years old. Due to poor compliance to therapy, she underwent a total thyroidectomy within 1 year of diagnosis. She remained well controlled on thyroid hormone replacement for over 20 years with Levothyroxine 100 μg daily. However, in the 2 years before referral to the Endocrine Clinic, she had difficult to treat hypothyroidism with persistent over-replacement; at the time ...

54 year old lady presented to the endocrine clinic. She was diagnosed with breast cancer and right ovarian tumour at the same time in August 2015. She had right lumpectomy of breast and Salpingo-Oophorectomy in November 2015. She was not feeling very well for the last few weeks. She complained of extreme lethargy and tiredness. She had blood test done on 15th November 2016 that showed prolactin level at 2849 nmmol/l with negative macroprolactin. Hence, she was referred to the ...