Endocrine Abstracts

42-year-old female with relapsing Graves’ disease treated with propylthiouracil (PTU) presented to the Emergency Department with a two-week history of fevers, night sweats, transient rash, arthralgia and fatigue. Five years previously she presented with Graves’ disease, TSH <0.02 mIU/l, FT4 of 39.8 pmol/l (9–16 pmol/l) and TSH receptor antibody positive with a titre of 11.3 IU/l. Initially treated with carbimazole therapy but developed an urticarial rash, lo...

Case presentation: A 35-year-old man presented to the emergency department (ED) in a confused and agitated state. His past medical history was significant for poorly controlled type 1 diabetes, complicated by background diabetic retinopathy. He was taking basal/bolus insulin and had a history of diabetic ketoacidosis (DKA) eleven years prior. He also had multiple sclerosis however disengaged with neurology services and was non-compliant with interferon therapy. Prior to admiss...

Case presentation: A 35-year-old man presented to the emergency department (ED) in a confused and agitated state. His past medical history was significant for poorly controlled type 1 diabetes, complicated by background diabetic retinopathy. He was taking basal/bolus insulin and had a history of diabetic ketoacidosis (DKA) eleven years prior. He also had multiple sclerosis however disengaged with neurology services and was non-compliant with interferon therapy. Prior to admiss...

A 47-year-old man attending Endocrine services for the management of Cushing’s disease in remission, presented with resistant hypertension which warranted further investigation. He initially presented in 2013 with Cushing’s disease and underwent successful transsphenoidal surgery. Postoperatively he was diagnosed with ACTH deficiency, partial growth hormone deficiency, and diabetes insipidus for which he was prescribed hydrocortisone 10 mg daily and desmotab 0.2 mg n...

Introduction: Cystic prolactinomas were historically considered resistant to dopamine agonists. However, recent case series including one by Faje et al. have highlighted their potential efficacy. We conducted an audit of cystic prolactinomas in Beaumont Hospital to assess this further. Methods: Cystic prolactinomas were defined as a macroadenoma with a cystic component exceeding 50% of the adenoma volume and a prolactin of at least 2,000mIU/l. Data was e...

A 58-year-old woman was referred for a short synacthen testing (SST) prior to discontinuing oral prednisolone (up to 10 mg/day), which had been administered for over several years for management of COPD. Her primary team noted features of presumed iatrogenic Cushing’s syndrome, including cervicodorsal fat pad, type 2 diabetes, dyslipidaemia, hypertension, osteopenia, NAFLD and anxiety, and sought to wean her off glucocorticoids to minimise further adverse effects. On exam...

Background: Improved survival rates from brain tumours have resulted in patients living longer with the effects of radiotherapy. Advances in conventional fractionated radiotherapy, such as intensity-modulated radiotherapy (IMRT), enable radiation to be delivered more precisely while partially sparing surrounding structures including the hypothalamic-pituitary axis. Despite these advances, the precise risk of hypopituitarism associated with IMRT in survivors of adult-onset non-...

Background: Intensity-modulated radiotherapy (IMRT) precisely delivers radiation to brain tumours while partially sparing surrounding structures like the hypothalamic-pituitary axis. The risk of hypopituitarism in survivors of adult-onset, primary, non-pituitary brain tumours following IMRT is poorly understood.Methods: We conducted a retrospective cohort study of brain tumour survivors undergoing endocrine surveillance in Beaumont Hospital. Patients wit...

A 47-year-old man attending with a history of Cushing’s disease in remission following transsphenoidal surgery in 2013 continued to experience resistant hypertension which warranted further investigation. Postoperatively he was prescribed hydrocortisone 10 mg twice daily and desmotab 0.2 mg nocte for ACTH deficiency and diabetes insipidus. Over the course of six years antihypertensive therapy escalated until he required five agents – ramipril 10 mg, amlodipine 10 mg,...

Adrenocortical carcinoma (ACC) is a rare aggressive tumour with median overall survival of 3-4years. Mitotane may be recommended for use in ACC in an adjuvant or palliative setting. It requires close clinical surveillance and therapeutic drug monitoring due to adverse effects and toxicity potential. This audit reviewed the management practices in patients with ACC prescribed mitotane therapy from 2010 to 2023 in Beaumont Hospital compared to the 2018 ESE/ENSAT clinical practic...